Organization
LOURDES PERINATOLOGY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER S KONCHAK D. O. (LEAD PHYSICIAN)
(856) 757-3993
Entity
Organization
Contact information
Practice address
1600 HADDON AVE, PERINATOLOGY, CAMDEN, NJ 08103-3101
(856) 757-3993
(856) 757-3045
Mailing address
1600 HADDON AVE, PERINATOLOGY, CAMDEN, NJ 08103-3101
(856) 757-3993
(856) 757-3045
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
25MB06099100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3197603
—
NJ
Enumeration date
05/23/2006
Last updated
08/22/2020
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