# KENNEDY MEDICAL GROUP PRACTICE, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KENNEDY MEDICAL GROUP PRACTICE, P.C.
- **Other names:** d/b/a/ Kennedy Health Alliance
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255743357
- **Legal business name:** KENNEDY MEDICAL GROUP PRACTICE, P.C.
- **Authorized official:** KATHERINE SCHLEIDER (VPCLINICAL INTEGRATION & POPULATION)
- **Authorized official phone:** (856) 783-1987

## Contact information

- **Practice address:** 524 WILLIAMSTOWN ROAD, SICKLERVILLE, NJ 08081
- **Practice address phone:** (856) 772-9600
- **Practice address fax:** (856) 772-9650
- **Mailing address:** 205 E. LAUREL ROAD, 2ND FLOOR, STRATFORD, NJ 08084
- **Mailing address phone:** (856) 783-1987
- **Mailing address fax:** (856) 783-1403

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 25MB03854300 | NJ | Yes |

## Other

- **Enumeration date:** 05/22/2014
- **Last updated:** 05/22/2014