Samuel Wolf Siegel-Wallace

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS020872 Issued in PA

Practice address

123 S Broad St Ste 2240
Philadelphia, PA 19109-1029

Phone

(267) 209-0140

NPI assigned

Oct 5, 2026

Last updated

Oct 5, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1791158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1306740469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S BROAD ST STE 2240",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191091029",
            "telephone_number": "267-209-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S BROAD ST STE 2240",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191091029",
            "telephone_number": "267-209-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL-WALLACE",
        "first_name": "SAMUEL",
        "middle_name": "WOLF",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-05",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS020872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sidney Hillman Ortho
• Sidney Hillman Podiatry
• Eliezer Sidon, MD
• Barbara Mary Siebert, DNP, CRNP, FNP-BC
• Hedy Lydia Siedarta
• Alyssa D Siegel, MD
• Andrew Michael Siegel, MD
• Arthur Siegel, MD
• Charles Graham Siegel, MD
• David M Siegel

• Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.