| Kennedy Medical Group Practice Pc | |
|
100 Kings Way E Suite D2 Sewell NJ 08080-2237 | |
| (856) 218-7730 | |
| (856) 218-4808 |
| Full Name | Kennedy Medical Group Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 100 Kings Way E, Sewell, New Jersey |
| Authorized Official Name and Position | Carmen Ciervo (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8565665202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennedy Medical Group Practice Pc 1099 White Horse Rd Voorhees NJ 08043-4405 Ph: (856) 566-5202 | Kennedy Medical Group Practice Pc 100 Kings Way E Suite D2 Sewell NJ 08080-2237 Ph: (856) 218-7730 |
| NPI Number | 1952848905 |
|---|---|
| Provider Enumeration Date | 01/30/2017 |
| Last Update Date | 01/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952848905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MA04155300 (New Jersey) | Primary |
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