KENNEDY MEDICAL GROUP D/B/A KENNEDY HEALTH ALLIANCE NPI 1790120152

NPI Information

NPI: 1790120152
Provider Name: KENNEDY MEDICAL GROUP D/B/A KENNEDY HEALTH ALLIANCE
Classification: Physician Assistant - 363AM0700X
Entity Type: Organization

Specialization: Medical

Address:
900 NEW JERSEY 168 NORTH
STE. C3
BLACKWOOD, NJ
ZIP 08012
Phone: (856) 374-0430
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KENNEDY MEDICAL GROUP D/B/A KENNEDY HEALTH ALLIANCE is a medical physician assistant in Blackwood, NJ. KENNEDY MEDICAL GROUP D/B/A KENNEDY HEALTH ALLIANCE NPI is 1790120152. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

900 NEW JERSEY 168 NORTH
STE. C3
BLACKWOOD, NJ
ZIP 08012
Phone: (856) 374-0430

The provider's authorized official is Katherine Schleider .
The authorized official title is Corporate Director and has the following contact phone number (856) 783-1987.

The enumeration date for this NPI number is 4/30/2013 and was last updated on 6/20/2013.

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
1	363AM0700X	Physician Assistant	Medical			Yes

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

NPI Synchronization or Removal

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