KENNEDY UNIVERSITY HOSPITAL, INC. (NPI# 1295751832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295751832 |
Entity Type | Organization |
Organization Name | KENNEDY UNIVERSITY HOSPITAL, INC. |
Other Organization Name | KENNEDY FAMILY HEALTH SERVICES |
Practice Address |
1 Somerdale Sq Somerdale NJ 08083-1345 |
Practice Telephone | 8565575555 |
Practice Fax Number | 8565668944 |
Mailing Telephone | 8565575555 |
Mailing Fax Number | 8565668942 |
Enumeration Date | 2006-07-15 |
Last Update Date | 2020-03-04 |
Authorized Official Name | MRS. MICHELLE SILLS (OFFICE MANAGER) |
Authorized Official Telephone | 8565575555 |
Is Organization Subpart | Y |
Parent Organization Name | KENNEDY MEMORIAL HOSPITAL UNIVERSITY MEDICAL CENTER, INC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | 10403 | NJ | Allopathic & Osteopathic Physicians |
N | 207V00000X | Obstetrics & Gynecology | 10403 | NJ | Allopathic & Osteopathic Physicians |
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
10403 | NJ | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NJ | 4140222 | 05 | |
NJ | 6843301 | 05 |
Other Name | Type Code |
---|---|
KENNEDY FAMILY HEALTH SERVICES | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851771117 | Kennedy University Hospital, Inc. | Obstetrics & Gynecology | 188 Fries Mill Rd, Suite N-1, Turnersville, NJ 08012-2015 | 2015-06-02 |
Street Address |
1 SOMERDALE SQ |
City | SOMERDALE |
State | NJ |
Zip Code | 08083-1345 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245218163 | Diana L Scott | Obstetrics & Gynecology | 1 Somerdale Sq, Somerdale, NJ 08083 | 2006-01-03 |
1033690318 | Natasha Halyard | Nurse Practitioner | 1 Somerdale Sq, Somerdale, NJ 08083-1345 | 2018-08-24 |
1568902146 | Kennedy University Hospital, Inc | Podiatrist | 1 Somerdale Sq, Somerdale, NJ 08083-1345 | 2017-03-02 |
1629481023 | Xiomara Penn-becoat | Pediatrics | 1 Somerdale Sq, Somerdale, NJ 08083-1345 | 2014-06-04 |
1366727281 | Kennedy University Hospitals | Urology | 1 Somerdale Sq, Somerdale, NJ 08083-1345 | 2011-10-12 |
1023391612 | Andrew Scott Blackstone | Urology | 1 Somerdale Sq, Somerdale, NJ 08083-1345 | 2011-09-21 |
1942511837 | Melissa Lehn Suarez | Obstetrics & Gynecology | 1 Somerdale Sq, Somerdale, NJ 08083-1345 | 2010-06-25 |
1144425554 | Catherine M Gerety | Nurse Practitioner | 1 Somerdale Sq, Somerdale, NJ 08083-1345 | 2007-06-16 |
1841229457 | Joseph L Gallagher IIi | Family Medicine | 1 Somerdale Sq, Somerdale, NJ 08083-1345 | 2006-07-03 |
1518996941 | Christopher J Barone | Family Medicine | 1 Somerdale Sq, Somerdale, NJ 08083-1345 | 2006-06-30 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053620351 | Wal-mart Stores East Lp | Technician/Technologist | 1 Coopertown Blvd, Somersdale, NJ 08083 | 2010-10-04 |
1336344548 | Diana Neal Juelg | Nurse Practitioner | 22 E. Evergreen Avenue, Somerdale, NJ 08083 | 2007-06-18 |
1598890295 | Shawn Thomas Klenk | Specialist/Technologist | 102 Rex Rd., Somerdale, NJ 08083 | 2007-02-22 |
1588741870 | John Raymond Tocco | Specialist | 701 W. Somerdale Road, Somerdale, NJ 08083 | 2006-11-01 |
1013552702 | Integrity Family Solutions | Community/Behavioral Health | 104 Kennedy Blvd, Somerdale, NJ 08083-1019 | 2019-11-17 |
1649373978 | Vijay K Kalola | Internal Medicine | 227 E Somerdale Rd, Somerdale, NJ 08083-1105 | 2006-09-05 |
1639260896 | Primary Care Affiliates of Nj, Pa | Internal Medicine | 227 E Somerdale Rd, Somerdale, NJ 08083-1105 | 2006-09-27 |
1932203171 | Jayesh Patel | Internal Medicine | 227 E Somerdale Rd, Somerdale, NJ 08083-1105 | 2006-09-08 |
1295727642 | Alan D Budman | Podiatrist | 301 E Somerdale Rd, Somerdale, NJ 08083-1107 | 2005-08-19 |
1124075643 | Alan D. Budman | Podiatrist | 301 E Somerdale Rd, Somerdale, NJ 08083-1107 | 2006-05-29 |
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Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.