KENNEDY MEDICAL GROUP PRACTICE, P.C. D/B/A KENNEDY HEALTH ALLIANCE (NPI# 1235517707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235517707 |
| Entity Type | Organization |
| Organization Name | KENNEDY MEDICAL GROUP PRACTICE, P.C. D/B/A KENNEDY HEALTH ALLIANCE |
| Practice Address |
205 E Laurel Rd 2nd Floor Stratford NJ 08084-1301 |
| Mailing Address |
100 Black Horse Pike Audubon NJ 08106-1950 |
| Practice Telephone | 8567831987 |
| Mailing Telephone | 8445422273 |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2015-07-29 |
| Authorized Official Name | KATHERINE SCHLEIDER (VP CLINICAL INTEGRATION) |
| Authorized Official Telephone | 8567831987 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174663470 | Kennedy Medical Group Practice, P.C. D/b/a Kennedy Health Alliance | Internal Medicine | 25 E Laurel Rd, Stratford, NJ 08084-1322 | 2007-02-07 |
| 1952786337 | Kennedy Medical Group Practice, P.C. D/b/a Kennedy Health Alliance | Internal Medicine | 333 Laurel Oak Rd, Voorhees, NJ 08043-4453 | 2015-07-27 |
| 1619365152 | Kennedy Medical Group Practice, P.C. D/b/a Kennedy Health Alliance | Internal Medicine | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2015-01-07 |
| 1902217607 | Kennedy Medical Group Practice, P.C. D/b/a Kennedy Health Alliance | Family Medicine | 1300 Liberty Pl, Sicklerville, NJ 08081-5710 | 2014-05-15 |
| Street Address |
205 E LAUREL RD 2ND FLOOR |
| City | STRATFORD |
| State | NJ |
| Zip Code | 08084-1301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477532802 | Jeffrey Friedman | Internal Medicine | 205 E Laurel Rd, 1st Floor, Stratford, NJ 08084-1301 | 2006-01-13 |
| 1821634239 | Justin Micheal Sullivan | Physician Assistant | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2019-11-20 |
| 1497218036 | Alicia Villaescusa Karagianes | Physician Assistant | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2019-04-10 |
| 1235619933 | Sierra Miller | Physician Assistant | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2018-08-21 |
| 1114426954 | Amy Carlin | Physician Assistant | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2018-02-07 |
| 1619365152 | Kennedy Medical Group Practice, P.C. D/b/a Kennedy Health Alliance | Internal Medicine | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2015-01-07 |
| 1437410990 | Kennedy Medical Group Practice, P.C. | Internal Medicine | 205 E Laurel Rd, 2nd Floor, Stratford, NJ 08084-1301 | 2012-05-31 |
| 1205114071 | Kennedy Medical Group Practice, P.C. | Internal Medicine | 205 E Laurel Rd, 1st Floor, Stratford, NJ 08084-1301 | 2011-07-28 |
| 1639120462 | Jeffery Ranalli | Internal Medicine | 205 E Laurel Rd, 1st Floor, Stratford, NJ 08084-1301 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780209684 | Emily Lacount | Student in an Organized Health Care Education/Training Program | Louis Balsama, D.o., Program Director, Rowansom 42 E. Laurel Rd, Stratford, NJ 08084 | 2020-06-16 |
| 1356903124 | Maziyar Daneshvar | Student in an Organized Health Care Education/Training Program | Rowansom 42 E Laurel Road, Suite 3100, Philadelphia, NJ 08084 | 2019-07-02 |
| 1598321788 | Sylvia Orozco Silberman | Student in an Organized Health Care Education/Training Program | Fm: Alison Mancuso, Do, Prog Dir, Rowansom 42 E Laurel Road, Suite 2100a, Stratford, NJ 08084 | 2019-05-14 |
| 1831682939 | Shriya Jakkidi Reddy | Student in an Organized Health Care Education/Training Program | Rowansom 42 E. Laurel Road, Suite 3100, Stratford, NJ 08084 | 2018-06-13 |
| 1003336751 | Maulik D Shah | Student in an Organized Health Care Education/Training Program | 42 East Laurel Rd, Suite 3100, Stratford, NJ 08084 | 2017-06-23 |
| 1225566946 | Bhumi Shah | Student in an Organized Health Care Education/Training Program | 18 E Laurel Road, Em: Anthony Dipasquale, Do, Prog Dir, Rowansom, Stratford, NJ 08084 | 2017-05-25 |
| 1902259393 | Ameena Javed Jiwani | Family Medicine | Rowan Som 42 E Laurel Road, Ste. 2100a, Stratford, NJ 08084 | 2016-07-20 |
| 1104276823 | Akshay Sridhar | Student in an Organized Health Care Education/Training Program | One Medical Center Drive, Suite 162, Stratford, NJ 08084 | 2016-06-14 |
| 1144692138 | Amanda Wu | Physical Therapist | 1255 Caldewell Road, Cherry Hill, NJ 08084 | 2015-10-29 |
| 1215313010 | Nathaniel Paul Havens | Student in an Organized Health Care Education/Training Program | 42 E. Laurel Rd., Suite 2100a, Stratford, NJ 08084 | 2015-08-04 |
| Find all providers in zip 08084 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164959276 | Steven Barrientos | Family Medicine | 42 E Laurel Rd Ste 2100a, Stratford, NJ 08084-1354 | 2017-05-19 |
| 1902259393 | Ameena Javed Jiwani | Family Medicine | Rowan Som 42 E Laurel Road, Ste. 2100a, Stratford, NJ 08084 | 2016-07-20 |
| 1881006401 | Body Intelligence Holistic Health Center, LLC | Family Medicine | 90 Sands Pl, Stratford, CT 06615-6661 | 2014-06-02 |
| 1962536888 | Brahman Bernard Levy | Family Medicine | 37 S White Horse Pike, Stratford, NJ 08084-1520 | 2007-03-15 |
| 1629178843 | Randolph Ramirez | Family Medicine | 2103 Main Street, Stratford, CT 06115 | 2006-09-25 |
| 1043325566 | Karen Ann Shulman | Family Medicine | 101 Wisconsin Ave, Stratford, WI 54484 | 2006-08-21 |
| 1518919893 | Hope S Honig | Family Medicine | 119 E Laurel Rd, Stratford, NJ 08084-1324 | 2006-05-16 |
| 1790765055 | Rowansom Dept of Family Practice | Family Medicine | 42 East Laurel Road, Udp, Suite 2100, Stratford, NJ 08084 | 2006-01-20 |
| 1295715787 | John F Bertagnolli Jr. | Family Medicine | 42 E Laurel Rd Ste 1800, Stratford, NJ 08084-1338 | 2006-01-19 |
| 1538149646 | Kathryn C Lambert | Family Medicine | 42 Laurel Rd E, Udp #2100, Stratford, NJ 08084-1354 | 2006-01-17 |
| Find all providers in STRATFORD | ||||
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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.