| Kennedy Health Alliance | |
|
100 Black Horse Pike Audubon NJ 08106-1950 | |
| (844) 542-2273 | |
| Not Available |
| Full Name | Kennedy Health Alliance |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 Black Horse Pike, Audubon, New Jersey |
| Authorized Official Name and Position | Carman Ciervo (CPE) |
| Authorized Official Contact | 8563447360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennedy Health Alliance 205 E Laurel Rd Stratford NJ 08084-1301 Ph: (856) 344-7360 | Kennedy Health Alliance 100 Black Horse Pike Audubon NJ 08106-1950 Ph: (844) 542-2273 |
| NPI Number | 1871039180 |
|---|---|
| Provider Enumeration Date | 01/10/2017 |
| Last Update Date | 01/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871039180 | NPI | - | NPPES |
| 041128 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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