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Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C.
Active
Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C.
Active
Parent organization
KENNEDY UNIVERSITY HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENNEDY UNIVERSITY HOSPITAL
Authorized official
CARMAN A CIERVO (CEO)
(856) 783-1987
Entity
Organization
Contact information
Practice address
73 N MAPLE AVE, SUITE B, MARLTON, NJ 08053-1782
(856) 596-0558
(856) 596-4043
Mailing address
333 LAUREL OAK RD, VOORHEES, NJ 08043-4453
(856) 566-5273
(856) 566-5283
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
2084N0400X
Neurology Physician
—
—
Other
Enumeration date
12/02/2010
Last updated
10/19/2017
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