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General NPI Number Information
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NPI Number | 1831369750
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Entity Type | Organization
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Legal Business Name | LOURDES MEDICAL ASSOCIATES, PA
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Dates
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Enumeration Date | 03/06/2008
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 2475 MCCLELLAN AVE SUITE B201
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City | PENNSAUKEN
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State | NJ
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Zip | 08109-4683
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Country | US
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Telephone | 856-330-6300
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Fax | 856-330-6305
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Provider Business Mailing Address
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Address Line | 500 GROVE ST STE 100
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City | HADDON HEIGHTS
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State | NJ
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Zip | 08035-1761
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Country | US
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Telephone | 856-796-9200
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Fax | 856-796-9397
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN FOX
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Credential | MD
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Telephone | 856-796-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA01990700
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License Number State | NJ
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