Provider Demographics
NPI:1831514017
Name:KERSMAN, MICHELE (PTA)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:KERSMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 WILDFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5811
Mailing Address - Country:US
Mailing Address - Phone:703-973-8330
Mailing Address - Fax:
Practice Address - Street 1:189 WILDFLOWER CIR
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5811
Practice Address - Country:US
Practice Address - Phone:703-973-8330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00302800225200000X
PATE010054225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant