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NPI Code Detail

MEDICARE: LOURDES MEDICAL ASSOCIATES PA

MEDICARE: LOURDES MEDICAL ASSOCIATES PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QS0010XSports Medicine (Family Medicine) Physician
2207R00000XInternal Medicine Physician
3207RG0100XGastroenterology Physician
4207RI0008XHepatology Physician
5207V00000XObstetrics & Gynecology Physician
6208000000XPediatrics Physician
7208600000XSurgery Physician
82086S0129XVascular Surgery Physician
92084N0400XNeurology Physician
10363AM0700XMedical Physician Assistant25MP00146900NJ
11208M00000XHospitalist Physician25MB06629000NJ
122086S0102XSurgical Critical Care Physician25MA03203600NJ
13204F00000XTransplant Surgery Physician
14207X00000XOrthopaedic Surgery Physician
15207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568441541
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOURDES MEDICAL ASSOCIATES PA
Provider Business Mailing Address
First Line : 500 GROVE ST.
Second Line : SUITE 100
City : HADDON HEIGHTS
State : NJ
Zip : 08035
Country : US
Telephone Number : 856-796-9200
Fax Number : 856-310-0592
Provider Business Practice Location Address
First Line : 500 GROVE ST
Second Line : SUITE 100
City : HADDON HEIGHTS
State : NJ
Zip : 08035-1702
Country : US
Telephone Number : 856-796-9200
Fax Number : 856-310-5603
Authorized Official
Title or Position : PRESIDENT
Name : DR. STEVEN FOX
Credential : MD
Telephone Number : 856-796-9200
Provider Enumeration Date : 01/10/2006
Last Update Date : 09/07/2023

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Directions to “LOURDES MEDICAL ASSOCIATES PA ” Practice Location

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