Organization
KENNEDY MEDICAL GROUP PRACTICE, P.C.
Active
Other names
Kennedy Health Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE SCHLEIDER (VPCLINICAL INTEGRATION & POPULATION)
(856) 783-1987
Entity
Organization
Contact information
Practice address
188 FRIES MILL RD, SUITE N3, BLACKWOOD, NJ 08012-2015
(856) 875-0505
(856) 875-9556
Mailing address
205 E LAUREL RD, 2ND FLOOR, STRATFORD, NJ 08084-1301
(856) 783-1987
(856) 783-1403
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3911101
—
NJ
01
—
P00633440
RAILROAD MEDICARE
NJ
Enumeration date
05/27/2014
Last updated
07/01/2015
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