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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
CARMAN CIERVO D.O. (CHIEF PHYSICIAN EXECUTIVE)
(856) 344-7360
Entity
Organization
Contact information
Practice address
630 B SOUTH WHITE HORSE PIKE, HAMMONTON, NJ 08037
(844) 542-2273
Mailing address
205 E LAUREL RD, STRATFORD, NJ 08084-1301
(856) 344-7360
(856) 344-2315
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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