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Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C.
Active
Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C.
Active
Other names
Kennedy Health Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO PEREZ (VICE PRESIDENT OF CLINICAL OPERATIO)
(856) 218-5634
Entity
Organization
Contact information
Practice address
205 E LAUREL RD, 2ND FLOOR, STRATFORD, NJ 08084-1301
(856) 816-0255
Mailing address
400 LAUREL OAK RD STE 105, VOORHEES, NJ 08043-4455
(856) 922-9894
(856) 922-9890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
05/31/2012
Last updated
11/18/2020
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