Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C. D/B/A KENNEDY HEALTH ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE SCHLEIDER (VP CLINICAL INTEGRATION)
(856) 344-7360
Entity
Organization
Contact information
Practice address
25 E LAUREL RD, STRATFORD, NJ 08084-1322
(856) 783-2244
(856) 783-8537
Mailing address
333 LAUREL OAK RD, VOORHEES, NJ 08043-4453
(856) 783-2244
(856) 783-8537
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL
NJ
01
—
00074869
PERSONAL CHOICE
NJ
01
—
0083883000
AMERIHEALTH
NJ
01
—
0482818000
KEYSTONE
NJ
01
—
0546509000
AMERIHEALTH
NJ
05
—
2320509
—
NJ
01
—
4090653
AETNA
NJ
01
—
5616786
AETNA
NJ
01
—
P1130008
OXFORD
NJ
Enumeration date
02/07/2007
Last updated
05/28/2020
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