| Organization Name: | KENNEDY UNIVERSITY HOSPITAL, INC |
| NPI Number: | 1205244910 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FELICIA NESMITH CUNNINGHAM (CORPORATE DIRECTOR) |
| Mailing Address: | 1300 Liberty Pl Lakeside Business Center Sicklerville |
| State: | NJ US |
| Postal Code: | 080815710 |
| Phone Number: | 8563097700 |
| Fax Number: | 8565668944 |
| NPI Enumeration Date: | 07/25/2014 |
| NPI Last Update Date: | 07/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |