Organization
KENNEDY MEDICAL GROUP PRACTICE P.C.
Active
Other names
Kennedy health Alliance, Kennedy Health Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARMAN A CIERVO D.O. (EXP/CPE)
(856) 344-7360
Entity
Organization
Contact information
Practice address
2211 CHAPEL AVENUE WEST, SUITE 301, CHERRY HILL, NJ 08002
(856) 665-2017
(856) 488-6769
Mailing address
205 E LAUREL RD, STRATFORD, NJ 08084-1301
(856) 344-2315
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0411248
—
NJ
Enumeration date
06/28/2017
Last updated
06/28/2017
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