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Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C.
Active
Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMAN A CIERVO (CEO)
(856) 783-1987
Entity
Organization
Contact information
Practice address
457 HADDONFIELD RD, STE. 110, CHERRY HILL, NJ 08002-2220
(856) 783-1987
(856) 783-1403
Mailing address
333 LAUREL OAK RD, VOORHEES, NJ 08043-4453
(856) 783-1987
(856) 783-1403
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
Other
Enumeration date
12/02/2015
Last updated
10/19/2017
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