Provider Demographics
NPI:1992781298
Name:KENT, MARIA C (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:C
Last Name:KENT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 BRIDGETON PIKE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-2669
Mailing Address - Country:US
Mailing Address - Phone:856-223-0500
Mailing Address - Fax:856-223-1098
Practice Address - Street 1:155 BRIDGETON PIKE
Practice Address - Street 2:SUITE A
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-2669
Practice Address - Country:US
Practice Address - Phone:856-223-0500
Practice Address - Fax:856-223-1098
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07547200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0013811Medicaid
NJ0013811Medicaid
NJ072995CX8Medicare PIN