Organization
KENNEDY MEDICAL GROUP P.C.
Active
Other names
kennedy Health Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
CARMAN A CIERVO D.O. (CPE)
(856) 344-7360
Entity
Organization
Contact information
Practice address
707 HADDONFIELD BERLIN RD, VOORHEES, NJ 08043-3714
(856) 857-6920
Mailing address
707 HADDONFIELD ROAD, VOORHEES, NJ 08084
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0411248
—
NJ
Enumeration date
02/06/2017
Last updated
02/09/2017
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