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KENNEDY MEDICAL GROUP PRACTICE P.C. NPI 1881138154


NPI Information

NPI: 1881138154
Provider Name: KENNEDY MEDICAL GROUP PRACTICE P.C.

Doing Business As: KENNEDY HEALTH ALLIANCE

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
630 B SOUTH WHITE HORSE PIKE
HAMMONTON, NJ
ZIP 08037
Phone: (844) 542-2273
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KENNEDY MEDICAL GROUP PRACTICE P.C. is an obstetrics gynecology in Hammonton, NJ. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. KENNEDY MEDICAL GROUP PRACTICE P.C. NPI is 1881138154. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Kennedy Health Alliance.

The provider's business location address is:

630 B SOUTH WHITE HORSE PIKE
HAMMONTON, NJ
ZIP 08037
Phone: (844) 542-2273

The provider's authorized official is Carman Ciervo .
The authorized official title is Chief Physician Executive and has the following contact phone number (856) 344-7360.

The enumeration date for this NPI number is 12/6/2016 and was last updated on 12/6/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineNo
3207V00000XObstetrics & GynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10411248MEDICAIDNEW JERSEY
2348438MEDICARE PINNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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