DR. ROBERT LAWRENCE RIDER (NPI# 1427432632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427432632 |
| Entity Type | Individual |
| Full Name | DR. ROBERT LAWRENCE RIDER |
| Credential | PH.D. |
| Practice Address |
4050 S 26th St Suite 140 Philadelphia PA 19112-1613 |
| Mailing Address |
473 King of Prussia Rd Radnor PA 19087-4518 |
| Practice Telephone | 2674632284 |
| Practice Fax Number | 2674682301 |
| Mailing Telephone | 2673042069 |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-12-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PS017874 | PA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 103062378 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497384333 | Robert Rider | Specialist | 2077 Miamisburg Centerville Rd, Dayton, OH 45459-3846 | 2020-04-03 |
| 1790799534 | Robert Fitzgerald Rider | Radiology | 1661 Soquel Drive, Building G, Santa Cruz, CA 95065-1709 | 2006-07-28 |
| Street Address |
4050 S 26TH ST SUITE 140 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19112-1613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174945422 | Tara Soprano | Specialist/Technologist | 4050 S 26th St, Philadelphia, PA 19112-1613 | 2014-01-06 |
| 1114397387 | Jian Li | Nurse Practitioner | 4050 S 26th St, Jefferson Comprehensive Concussion Center, Philadelphia, PA 19112-1613 | 2015-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265950802 | M&m Surgical Center PC | Clinic/Center | 1 Crescent Dr. Suite 300, Philadelphia, PA 19112 | 2017-09-05 |
| 1710114293 | Riverview Surgery Center At The Navy Yard Lp | Clinic/Center | Three Crescent Drive, Navy Yard Corporate Center, Philadelphia, PA 19112 | 2009-06-11 |
| 1023136942 | Susan Elizabeth Fredericks | Physician Assistant | 1 Crescent Drive Suite 100, Navy Yard Corporate Center, Philadelphia, PA 19112 | 2007-03-27 |
| 1023132867 | Healthmark, Incorporated | Clinic/Center | 1 Crescent Dr., Navy Yard Suite 100, Philadelphia, PA 19112 | 2007-03-19 |
| 1932526258 | Anne Catherine Kane | Otolaryngology | 3 Crescent Dr, Philadelphia, PA 19112 | 2014-03-25 |
| 1255539896 | Sheldon Gottlieb | Physical Medicine & Rehabilitation | 1 Crescent Dr, Suite 100, Philadelphia, PA 19112 | 2007-07-05 |
| 1407074750 | Jennifer L Johansen | Pharmacist | 5 Crescent Dr, Ny0200, Philadelphia, PA 19112-1001 | 2007-04-23 |
| 1679981708 | Andrew Trofa | Internal Medicine | 5 Crescent Dr, Ny 0300, Philadelphia, PA 19112-1001 | 2014-08-01 |
| 1508029463 | Robert Williams Carr | Preventive Medicine | 5 Crescent Dr, Ny 0300, Philadelphia, PA 19112-1001 | 2008-07-09 |
| 1952947152 | Navy Yard Dental Associates, Pllc | Dentist | 1 Crescent Dr Ste 300, Philadelphia, PA 19112-1015 | 2019-11-22 |
| Find all providers in zip 19112 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| 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. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467092312 | Katie Fabius | Clinical Neuropsychologist | 230 S Broad St Ste 1005, Philadelphia, PA 19102-4105 | 2020-01-08 |
| 1609228022 | Michael E. Keesler | Clinical Neuropsychologist | 77 Rochelle Ave, Philadelphia, PA 19128-3809 | 2016-07-09 |
| 1023463106 | Chelsea Black | Clinical Neuropsychologist | 3405 Civic Center Blvd Rm 107, Philadelphia, PA 19104-4319 | 2016-04-26 |
| 1285088914 | Megan Alana Perrin | Clinical Neuropsychologist | 1510 Manton St, Philadelphia, PA 19146-3129 | 2016-04-19 |
| 1104207190 | Kelly M. Janke | Clinical Neuropsychologist | 3501 Civic Center Blvd # 10209, Philadelphia, PA 19104-3820 | 2015-06-15 |
| 1861637381 | Dr. Shan Psychiatry Clinic LLC | Clinical Neuropsychologist | 756 Adams Ave, Philadelphia, PA 19124-2330 | 2008-12-12 |
| 1225184468 | Cornelius Furgueson | Clinical Neuropsychologist | 1801 Vine St, Room 149-mg, Philadelphia, PA 19103-1117 | 2007-01-27 |
| 1588711006 | Diversified Psychological Resources, P.C. | Clinical Neuropsychologist | 230 S. Broad St., Suite 1005, Philadelphia, PA 19102-4105 | 2007-01-05 |
| 1407879430 | Carol L Armstrong | Clinical Neuropsychologist | 100 N 20th St, Philadelphia, PA 19103-1443 | 2006-07-25 |
| 1558381251 | Edward A Maitz | Clinical Neuropsychologist | 117 S 17th St, Suite 1700, Philadelphia, PA 19103-5025 | 2006-07-19 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19112 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.