# KENNEDY MEDICAL GROUP PRACTICE P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KENNEDY UNIVERSITY HOSPITAL
- **Other names:** Kennedy Health Alliance
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1952615981
- **Legal business name:** KENNEDY UNIVERSITY HOSPITAL
- **Authorized official:** KATHERINE SCHLEIDER (VP CLINICAL INTEGRATION)
- **Authorized official phone:** (856) 783-1892

## Contact information

- **Practice address:** 165 PRINCETON AVE, WEST DEPTFORD, WEST DEPTFORD, NJ 08096-3123
- **Practice address phone:** (856) 384-0210
- **Practice address fax:** (856) 384-0218
- **Mailing address:** 205 E. LAUREL ROAD, STRATFORD, NJ 08084
- **Mailing address phone:** (856) 783-1987
- **Mailing address fax:** (856) 783-1403

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 25MB08173000 | NJ | Yes |

## Other

- **Enumeration date:** 08/02/2010
- **Last updated:** 07/10/2014