Individual
DR. KENNEDY U GANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
651 JOHN F KENNEDY WAY, WILLINGBORO, NJ 08046-1262
(609) 835-2838
(609) 589-3841
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA08152400
NJ
2083C0008X
Clinical Informatics Physician
25MA08152400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0146471
—
NJ
Enumeration date
08/23/2007
Last updated
04/12/2024
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