IndividualActive
Michael Broder, PH.D.
NPI 1003031154 · Psychologist · Philadelphia, PA
Provider details
- NPI number
- 1003031154
- Entity type
- Individual
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- PS003069-L (PA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
1420 Locust St
7g
Philadelphia, PA 19102-4223
Phone: (215) 545-7000
Fax: (215) 545-7011
Approximate (ZIP-level) locationGet directions
Mailing address
1420 Locust St
Philadelphia, PA 19102-4223
Registry dates
- Enumerated
- 2007-04-16
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.