Provider Demographics
NPI:1851771117
Name:KENNEDY UNIVERSITY HOSPITAL, INC.
Entity Type:Organization
Organization Name:KENNEDY UNIVERSITY HOSPITAL, INC.
Other - Org Name:KENNEDY OB/GYN ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NESMITH-CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-309-7726
Mailing Address - Street 1:1 SOMERDALE SQ
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-1345
Mailing Address - Country:US
Mailing Address - Phone:856-309-7700
Mailing Address - Fax:
Practice Address - Street 1:188 FRIES MILL RD
Practice Address - Street 2:SUITE N-1
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2015
Practice Address - Country:US
Practice Address - Phone:856-875-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENNEDY UNIVERSITY HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty