# KENNEDY MEDICAL GROUP PRACTICE, P.C.D/B/A KENNEDY HEALTH ALLIANCE

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

## Provider details

- **NPI number:** 1154347367
- **Authorized official:** DEBBIE O'NEIL (CREDENTIALING)
- **Authorized official phone:** (856) 783-1987

## Contact information

- **Practice address:** 151 FRIES MILL RD, SUITE 400, TURNERSVILLE, NJ 08012
- **Practice address phone:** (856) 401-9300
- **Practice address fax:** (856) 374-5805
- **Mailing address:** 151 FRIES MILL RD, SUITE 400, TURNERSVILLE, NJ 08012
- **Mailing address phone:** (856) 401-9300
- **Mailing address fax:** (856) 374-5805

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/14/2006
- **Last updated:** 03/27/2015