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General NPI Number Information
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NPI Number | 1497643514
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Entity Type | Organization
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Legal Business Name | NEURODYNAMIX TESTING AND THERAPY SOLUTIONS PLLC
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 128 CHESTNUT ST STE 404B
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City | PHILADELPHIA
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State | PA
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Zip | 19106-3024
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Country | US
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Telephone | 215-586-2448
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Fax |
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Provider Business Mailing Address
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Address Line | 419 COUNTRYSIDE DR
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City | EPHRATA
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State | PA
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Zip | 17522-9629
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Country | US
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Telephone | 215-586-2448
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | DR. NOAH EDWARD SIDEMAN
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Credential | PSYD
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Telephone | 215-586-3448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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