Organization · Type 2 NPI
Kennedy Medical Group D/b/a Kennedy Health Alliance
Medical Physician Assistant · Blackwood, NJ
NPI number
1790120152
Active
Practice location
900 New Jersey 168 North, Ste. C3
Blackwood, NJ 08012
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | None listed |
Medical Physician Assistant: Definition to come...
About NPI 1790120152
Kennedy Medical Group D/b/a Kennedy Health Alliance's National Provider Identifier is 1790120152, issued on Apr 30, 2013. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Blackwood, NJ. The record was last updated on Jun 20, 2013.