Organization
LOURDES MEDICAL ASSOCIATES, PA
Active
Parent organization
LOURDES MEDICAL ASSOCIATES, PA
Other names
Lourdes Medical Associates- Surgical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOURDES MEDICAL ASSOCIATES, PA
Authorized official
DR. STEVEN FOX MD (PRESIDENT)
(856) 796-9200
Entity
Organization
Contact information
Practice address
120 WHITE HORSE PIKE, SUITE 103, HADDON HEIGHTS, NJ 08035
(856) 546-3900
(856) 546-3908
Mailing address
500 GROVE ST, SUITE 100, HADDON HEIGHTS, NJ 08035-1761
(856) 796-9200
(856) 796-9397
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6535704
MEDICAID GROUP
NJ
05
—
6535704
—
NJ
01
—
683572
MEDICARE GROUP
NJ
Enumeration date
05/20/2011
Last updated
04/08/2015
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