Organization
KENNEDY MEDICAL GROUP PRACTICE P.C.
Active
Other names
Kennedy Health Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
CARMAN CIERVO D.O. (CPE)
(856) 344-7360
Entity
Organization
Contact information
Practice address
709 HADDONFIELD BERLIN RD, VOORHEES, NJ 08043-3714
(856) 566-3190
(856) 566-1903
Mailing address
709 HADDONFIELD BERLIN RD, VOORHEES, NJ 08043-3714
(856) 566-3190
(856) 566-1903
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0411248
—
NJ
05
—
6270204
—
NJ
01
—
CA2405
RAILROAD MEDICARE
NJ
Enumeration date
07/17/2006
Last updated
03/01/2017
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