Organization
KENNEDY MEDICAL GROUP PRACTICE PC
Active
Other names
Kennedy Health Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN CIERVO DO (CHIEF EXECUTIVE OFFICER)
(856) 566-5202
Entity
Organization
Contact information
Practice address
100 KINGS WAY E, SUITE D2, SEWELL, NJ 08080-2237
(856) 218-7730
(856) 218-4808
Mailing address
1099 WHITE HORSE RD, VOORHEES, NJ 08043-4405
(856) 566-5202
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA04155300
NJ
Other
Enumeration date
01/30/2017
Last updated
01/30/2017
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