Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kendall Park Medical Group

Organization Family Medicine Physician · NPI 1477784155

Kendall Park Medical Group is a Family Medicine Physician in Kendall Park, New Jersey. Licensed in New Jersey. Registered with an NPI since 2009.

Licensed in
NJ
In the registry since
2009

Practice location Address checks out

3 Stanworth Rd # A
Kendall Park, NJ 08824-1003
Phone: (732) 940-0505
Fax: (732) 940-1997
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 25MA04235300 (NJ)

Record details

NPI number1477784155
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jaime Lara — Physician · (732) 940-0505
NPI enumeratedJuly 29, 2009
Last updated in NPPESJuly 29, 2009
Mailing address3 Stanworth Rd # A, Kendall Park, NJ 08824-1003

Other providers in Kendall Park