=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336103845
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN J KERNIS M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2006
-----------------------------------------------------
Last Update Date | 07/13/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 151 FRIES MILL RD STE 105
-----------------------------------------------------
City | TURNERSVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08012-2056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-212-0130
-----------------------------------------------------
Fax | 856-212-0135
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 151 FRIES MILL RD STE 105
-----------------------------------------------------
City | TURNERSVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08012-2056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-212-0130
-----------------------------------------------------
Fax | 856-212-0135
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | MD459750
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number | 25MA082185
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number | MD459750
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 25MA08218500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------