OrganizationActive
Kennedy Medical Group Practice P.C.
NPI 1497295109 · Prescribing (Medical) Psychologist · Blackwood, NJ
Provider details
- NPI number
- 1497295109
- Entity type
- Organization
- Primary specialty
- Prescribing (Medical) PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Carman Ciervo, Cpe(856) 344-7360
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Psychologist103T00000X
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
900 Route 168
Suite C#3
Blackwood, NJ 08012-3233
Phone: (856) 857-6920
Approximate (ZIP-level) locationGet directions
Mailing address
900 Route 168
Blackwood, NJ 08012-3233
Other names (DBA / former)
- Doing business as
- Kennedy Health Alliance
Registry dates
- Enumerated
- 2017-02-28
- Last updated
- 2017-02-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.