Individual
DR. ROBERT LAWRENCE RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4050 S 26TH ST, SUITE 140, PHILADELPHIA, PA 19112-1613
(267) 463-2284
(267) 468-2301
Mailing address
473 KING OF PRUSSIA RD, RADNOR, PA 19087-4518
(267) 304-2069
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS017874
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103062378
—
PA
Enumeration date
07/17/2015
Last updated
12/30/2015
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