Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C.
Active
Other names
Kennedy Health Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO PEREZ (VICE PRESIDENT OF CLINICAL OPERATIO)
(856) 218-5634
Entity
Organization
Contact information
Practice address
205 E LAUREL RD, 2ND FLOOR, STRATFORD, NJ 08084-1301
(856) 816-0255
Mailing address
400 LAUREL OAK RD STE 105, VOORHEES, NJ 08043-4455
(856) 922-9894
(856) 922-9890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
05/31/2012
Last updated
11/18/2020
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