Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C.
Active
Parent organization
KENNEDY UNIVERSITY HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENNEDY UNIVERSITY HOSPITAL
Authorized official
CARMAN A CIERVO (CEO)
(856) 783-1987
Entity
Organization
Contact information
Practice address
73 N MAPLE AVE, SUITE B, MARLTON, NJ 08053-1782
(856) 596-0558
(856) 596-4043
Mailing address
333 LAUREL OAK RD, VOORHEES, NJ 08043-4453
(856) 566-5273
(856) 566-5283
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
2084N0400X
Neurology Physician
—
—
Other
Enumeration date
12/02/2010
Last updated
10/19/2017
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