KENNEDY MEDICAL GROUP PRACTICE, PC (NPI# 1982069688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982069688 |
| Entity Type | Organization |
| Organization Name | KENNEDY MEDICAL GROUP PRACTICE, PC |
| Practice Address |
151 Fries Mill Rd Ste 102 Turnersville NJ 08012-2056 |
| Mailing Address |
333 Laurel Oak Rd Voorhees NJ 08043-4453 |
| Practice Telephone | 8563526660 |
| Practice Fax Number | 8562694258 |
| Mailing Telephone | 8567831987 |
| Mailing Fax Number | 8567831403 |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | CARMAN A CIERVO (CEO) |
| Authorized Official Telephone | 8567831987 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 73 N Maple Ave, Ste. B, Marlton, NJ 080531782 | 8567831987 | 8567831403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316302003 | Kennedy Medical Group Practice, PC | Surgery | 1300 Liberty Pl, Sicklerville, NJ 08081-5710 | 2015-12-22 |
| 1932564622 | Kennedy Medical Group Practice, PC | Internal Medicine | 165 Princeton Ave, West Deptford, NJ 08096-3123 | 2015-12-22 |
| 1962867671 | Kennedy Medical Group Practice, PC | Internal Medicine | 333 Laurel Oak Rd, Voorhees, NJ 08043-4453 | 2015-12-22 |
| Street Address |
151 FRIES MILL RD STE 102 |
| City | TURNERSVILLE |
| State | NJ |
| Zip Code | 08012-2056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003158247 | Joseph L Derose | Internal Medicine | 151 Fries Mill Rd Ste 102, Turnersville, NJ 08012-2056 | 2013-03-26 |
| 1629464961 | Solomon Kyaka Bisangwa | Internal Medicine | 151 Fries Mill Rd Ste 102, Turnersville, NJ 08012-2056 | 2015-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740898550 | Caroline I Scott | In Home Supportive Care | 60 Lawrence Ln, Blackwood, NJ 08012 | 2020-07-17 |
| 1073154092 | Gina Marie Romano | Behavioral Analyst | 12 Braemar Ave, Blackwood, NJ 08012 | 2019-10-01 |
| 1245745777 | Chandler Group Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3408 Hight Street, Blackwood, NJ 08012 | 2017-12-06 |
| 1962917625 | Dpsp Health Care LLC | Home Health | 860 Rt. 168, Suite 207, Turners Ville, NJ 08012 | 2017-12-04 |
| 1871003103 | Sayana Modi LLC | Pharmacy | 460 Hurffville Crosskeys Rd, Tunersville, NJ 08012 | 2017-09-30 |
| 1427590827 | Cillo Chiropractic LLC | Chiropractor | 10 Woodlane Drive, Blackwood, NJ 08012 | 2016-11-16 |
| 1609327006 | Lena F Robinson | Registered Nurse | 435 Huffville Crosskeys Road, Turnersville, NJ 08012 | 2016-10-20 |
| 1316493026 | Partners In Homecare Services | In Home Supportive Care | 400 East Church St ., Blackwood, NJ 08012 | 2016-09-01 |
| 1710357710 | Wendy Hughes | Counselor | 900 Route 168 Ste B6, Turnersville, NJ 08012 | 2015-10-02 |
| 1043602337 | Erika White | Pharmacy Technician | 4001 State Route 42, Turnersville, NJ 08012 | 2015-02-24 |
| Find all providers in zip 08012 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841597762 | Comprehensive Neurology Services LLC | Psychiatry & Neurology | 188 Fries Mill Rd, Suite N-3, Turnersville, NJ 08012-2015 | 2011-02-14 |
| 1710143656 | David Alexander Roshal | Psychiatry & Neurology | 435 Hurffville Cross Keys Rd, Turnersville, NJ 08012-2453 | 2008-07-30 |
| 1558459511 | Anca Popescu | Psychiatry & Neurology | 435 Hurffville Cross Keys Rd, Turnersville, NJ 08012-2453 | 2006-10-11 |
| 1801825773 | Neurology and Neurophysiology Associates of Nj, P.C. | Psychiatry & Neurology | 151 Fries Mill Rd, Suite 506, Turnersville, NJ 08012-2016 | 2006-07-02 |
| 1649228248 | Dahlia J Irby | Psychiatry & Neurology | 188 Fries Mill Rd, Suite N-3, Turnersville, NJ 08012-2015 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831717719 | Hudson Healthcare Express LLC | Psychiatry & Neurology | 9225 Kennedy Blvd Ste D, North Bergen, NJ 07047-5361 | 2020-07-08 |
| 1225660947 | Harmony Direct Psychiatric Clinic | Psychiatry & Neurology | 332 Cranbury Rd, East Brunswick, NJ 08816-3074 | 2020-02-11 |
| 1548804909 | Stc Pediatrics LLC | Psychiatry & Neurology | 100 Kings Way E Ste C, Sewell, NJ 08080-2238 | 2019-10-29 |
| 1356902134 | Balance Dizziness Center Inc. | Psychiatry & Neurology | 17 Brinkerhoff Terrace, Palisades Park, NJ 07650 | 2019-06-24 |
| 1821555376 | Executive Center for Psychological Medicine | Psychiatry & Neurology | 701 White Horse Rd Ste C-101, Voorhees, NJ 08043-2494 | 2019-02-20 |
| 1871058446 | Midatlantic Neuromonitoring Limited | Psychiatry & Neurology | 125 Half Mile Rd Ste 200, Red Bank, NJ 07701-6749 | 2019-02-07 |
| 1083120570 | Ah Medical PC | Psychiatry & Neurology | 3600 Bergenline Ave 2nd Floor, Ste 8, Union City, NJ 07087 | 2017-12-19 |
| 1225551146 | Bindi Akshay Patel | Psychiatry & Neurology | 125 Paterson St Ste 6100, New Brunswick, NJ 08901-1962 | 2017-07-23 |
| 1841647823 | Joshua Daniel | Psychiatry & Neurology | 58 W Aspen Way, Aberdeen, NJ 07747-1906 | 2016-05-19 |
| 1487059978 | Neurological Institute of Northern New Jersey | Psychiatry & Neurology | 3 Wedgewood Dr, West Orange, NJ 07052-2719 | 2014-10-27 |
| Find all providers with the same taxonomy | ||||
| City | TURNERSVILLE |
| Zip Code | 08012 |
Please comment or provide details below to improve the information on KENNEDY MEDICAL GROUP PRACTICE, PC.
| 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.