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NPI Code Detail

MEDICARE: MS. LISA SEMELS M.S.P.T.

MEDICARE: MS. LISA SEMELS M.S.P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistPT010142LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12083306000OTHERPABC/BS HMO
21394051OTHERPABC/BS PPO
3000810593243OTHERPAPHCS
47311639OTHERPAAETNA

General Provider Information

NPI Number : 1356342372
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA SEMELS M.S.P.T.
Provider Business Mailing Address
First Line : 420 BAINBRIDGE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19147-1568
Country : US
Telephone Number : 215-629-3837
Fax Number : 215-629-5531
Provider Business Practice Location Address
First Line : 734 E LANCASTER AVE
Second Line :
City : VILLANOVA
State : PA
Zip : 19085-1325
Country : US
Telephone Number : 610-964-1700
Fax Number : 610-688-2000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 04/17/2008

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