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Organization
KENNEDY MEDICAL GROUP PRACTICE PC
Active
Organization
KENNEDY MEDICAL GROUP PRACTICE PC
Active
Other names
Kennedy Health Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN CIERVO DO (CHIEF EXECUTIVE OFFICER)
(856) 566-5202
Entity
Organization
Contact information
Practice address
100 KINGS WAY E, SUITE D2, SEWELL, NJ 08080-2237
(856) 218-7730
(856) 218-4808
Mailing address
1099 WHITE HORSE RD, VOORHEES, NJ 08043-4405
(856) 566-5202
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA04155300
NJ
Other
Enumeration date
01/30/2017
Last updated
01/30/2017
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