Provider Demographics
NPI:1821528753
Name:KENNEDY CHERRY HILL SURGICAL CENTER LLC
Entity type:Organization
Organization Name:KENNEDY CHERRY HILL SURGICAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BOARD CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-295-9041
Mailing Address - Street 1:PO BOX 7010
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-0010
Mailing Address - Country:US
Mailing Address - Phone:913-647-6475
Mailing Address - Fax:
Practice Address - Street 1:2211 CHAPEL AVE W STE 200
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2048
Practice Address - Country:US
Practice Address - Phone:856-295-9041
Practice Address - Fax:856-295-9042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical