Provider Demographics
NPI:1144257502
Name:SIROLLY, KENDRA WALKER (MD)
Entity type:Individual
Prefix:DR
First Name:KENDRA
Middle Name:WALKER
Last Name:SIROLLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KENDRA
Other - Middle Name:MARIE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:401 ROUTE 73 N STE 320
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3426
Mailing Address - Country:US
Mailing Address - Phone:609-924-4892
Mailing Address - Fax:877-409-2156
Practice Address - Street 1:281 WITHERSPOON ST STE 200
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3224
Practice Address - Country:US
Practice Address - Phone:609-924-4892
Practice Address - Fax:877-409-2156
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427522208000000X
NJ25MA09908100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100485OtherGEISINGER
PA1808808OtherHIGHMARK BLUE SHIELD
PA20049243OtherAH MERCY-WMG S GEO ST
PA50056182OtherCAPITAL BLUE CROSS-WMG
PA102603OtherJOHNS HOPKINS
PA176440OtherUNISON-WMG
MD648832OtherCAREFIRST MD BCBS
PA7336926OtherAETNA
PA20049244OtherAH MERCY-WMG WINDSOR RD
PAP006962OtherGATEWAY-WMG
PA2143982OtherMAMSI-WMG
PA101470031Medicaid
PA20049244OtherAH MERCY-WMG WINDSOR RD
PA173797FLTMedicare PIN