# LOURDES PERINATOLOGY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538114327
- **Authorized official:** PETER S KONCHAK D. O. (LEAD PHYSICIAN)
- **Authorized official phone:** (856) 757-3993

## Contact information

- **Practice address:** 1600 HADDON AVE, PERINATOLOGY, CAMDEN, NJ 08103-3101
- **Practice address phone:** (856) 757-3993
- **Practice address fax:** (856) 757-3045
- **Mailing address:** 1600 HADDON AVE, PERINATOLOGY, CAMDEN, NJ 08103-3101
- **Mailing address phone:** (856) 757-3993
- **Mailing address fax:** (856) 757-3045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VM0101X | Maternal & Fetal Medicine Physician | 25MB06099100 | NJ | Yes |

## Other

- **Enumeration date:** 05/23/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3197603 | — | NJ |