Individual
DR. KELLY DAVID KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
6 EAST FIRST AVENUE, RUNNEMEDE, NJ 08078-1101
(856) 939-2042
(856) 939-1341
Mailing address
6 EAST FIRST AVENUE, RUNNEMEDE, NJ 08078-1101
(856) 939-2042
(856) 939-1341
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00256200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0073687000
AMERIHEALTH
NJ
01
—
1084117
HORIZON MERCEY
NJ
05
—
192260201
—
NJ
01
—
23278
AMERICAID
NJ
01
—
702524
UNITED HEALTHCARE
NJ
01
—
CA000004801
AMERICHOICE
NJ
01
—
P441526
OXFORD
NJ
Enumeration date
08/05/2006
Last updated
09/21/2011
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