Kennedy Medical Group Practice P.c.

NPI #1871039180 in Audubon, New Jersey

Provider Information

NPI Number: 1871039180
Entity Type: Organization
Organization Name: Kennedy Medical Group Practice P.c.
Primary Specialty: Internal Medicine
Enumeration Date: Jan 10, 2017
Last Updated: Jan 10, 2017

Practice Location

Address: 100 BLACK HORSE PIKE
City: Audubon
State: New Jersey
ZIP Code: 08106-1950
Phone: (844) 542-2273

Authorized Official

Name: CARMAN CIERVO, D.O.
Title: CPE
Phone: (856) 344-7360

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Internal Medicine	207R00000X	Primary

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