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
1305 KINGS HWY N, N#4, CHERRY HILL, NJ 08034-1919
(844) 542-2273
Mailing address
205 E LAUREL RD, STRATFORD, NJ 08084-1301
(856) 344-7360
(856) 344-2315
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0411248
—
NJ
Enumeration date
12/09/2016
Last updated
12/09/2016
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