Doctor Name: | DR. ROBERT LAWRENCE RIDER |
NPI Number: | 1427432632 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PS017874 |
Business Practice Address: | 4050 S 26th St Suite 140 Philadelphia, PA - 191121613 |
Business Phone Number: | 2674632284 |
Business Fax Number: | 2674682301 |
Mailing Address: | 473 King Of Prussia Rd, RADNOR |
State: | PA |
Postal Code: | 190874518 |
Phone Number: | 2673042069 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2015 |
NPI Last Update Date: | 12/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PS017874 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |