Kennedy Medical Group Practice, P.C.
Family Medicine in Marlton, NJ. Organization (NPI-2).
NPI number1427350040
StatusActive
Last updated in NPPESOct 19, 2017
Details
- NPI
- 1427350040
- Entity type
- Organization (NPI-2)
- Legal business name
- Kennedy Medical Group Practice, P.C.
- Organization subpart
- Yes
- Enumeration date
- Dec 2, 2010
- Last updated
- Oct 19, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207RG0100X | Internal Medicine, Gastroenterology | – | – | |
| 2084N0400X | Psychiatry & Neurology, Neurology | – | – |
Practice location
73 N Maple AveSuite B
Marlton, NJ 08053-1782
Phone 856-596-0558 · Fax 856-596-4043
Mailing address
333 Laurel Oak RdVoorhees, NJ 08043-4453
Phone 856-566-5273 · Fax 856-566-5283
Authorized official
Carman A Ciervo
Ceo
8567831987
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