| Kennedy Medical Group Practice P.c. | |
|
900 Route 168 Suite C#3 Blackwood NJ 08012-3233 | |
| (856) 857-6920 | |
| Not Available |
| Full Name | Kennedy Medical Group Practice P.c. |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 900 Route 168, Blackwood, New Jersey |
| Authorized Official Name and Position | Carman A Ciervo (CPE) |
| Authorized Official Contact | 8563447360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennedy Medical Group Practice P.c. 900 Route 168 Suite C#3 Blackwood NJ 08012-3233 Ph: () - | Kennedy Medical Group Practice P.c. 900 Route 168 Suite C#3 Blackwood NJ 08012-3233 Ph: (856) 857-6920 |
| NPI Number | 1497295109 |
|---|---|
| Provider Enumeration Date | 02/28/2017 |
| Last Update Date | 02/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497295109 | NPI | - | NPPES |
| 0411248 | Medicaid | NJ |
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