NPI 1003031154

Michael S. Broder, PHD

Practitioner Psychologist Philadelphia, PA

Practice location

Address: 1420 Locust St 7g, Philadelphia, PA 19102-4223
Phone: (215) 545-7000
Fax: (215) 545-7011

Registered specialties

Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103T00000X Licence PS003069-L (PA)

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Registry record

NPI: 1003031154
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Apr 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.