Basic Information
| Provider Information | |||||||||
| NPI: | 1912202557 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LOURDES CARDIOLOGY SERVICES, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 63 KRESSON RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080343200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564284100 | ||||||||
| FaxNumber: | 8564285748 | ||||||||
| Practice Location | |||||||||
| Address1: | 63 KRESSON RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080343200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564284100 | ||||||||
| FaxNumber: | 8564285748 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2011 | ||||||||
| LastUpdateDate: | 10/24/2012 | ||||||||
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| AuthorizedOfficialLastName: | POPE | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
| AuthorizedOfficialMiddleName: | R. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8564291800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0001X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | 207RI0011X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207RC0000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.