Organization
LOURDES IMAGING ASSOCIATES PA
Active
Other names
PA
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH BENJAMIN BROUDY MD (PRESIDENT)
(330) 412-3057
Entity
Organization
Contact information
Practice address
1600 HADDON AVENUE, CAMDEN, NJ 08103-3117
(330) 412-3057
Mailing address
PO BOX 31037, NEWARK, NJ 07101
(614) 689-1691
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7224702
—
NJ
Enumeration date
07/03/2006
Last updated
08/23/2024
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