Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C.
Active
Other names
Kennedy Health Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
CARMAN CIERVO (CPE)
(856) 344-7360
Entity
Organization
Contact information
Practice address
2211 CHAPEL AVE WEST, STE 301, CHERRY HILL, NJ 08002
(856) 665-2017
(856) 488-6769
Mailing address
333 LAUREL OAK RD, VOORHEES, NJ 08043-4453
(856) 783-1987
(856) 783-1403
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0411248
—
NJ
Enumeration date
12/02/2015
Last updated
07/21/2022
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