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. (CHIEF PHYSICIAN EXECUTIVE)
(856) 344-7360
Entity
Organization
Contact information
Practice address
630 B SOUTH WHITE HORSE PIKE, HAMMONTON, NJ 08037
(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
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0411248
—
NJ
Enumeration date
12/06/2016
Last updated
12/06/2016
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