Healthcare Provider Details
I. General information
NPI: 1295558674
Provider Name (Legal Business Name): ADVOCARE , LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/05/2024
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
722 YORKLYN RD STE 100
HOCKESSIN DE
19707-8746
US
IV. Provider business mailing address
401 ROUTE 73 N BLDG 10, SUITE 320
MARLTON NJ
08053
US
V. Phone/Fax
- Phone: 302-235-1188
- Fax: 302-239-2604
- Phone: 856-872-7055
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAWN
M
CANDIA
Title or Position: DIRECTOR
Credential:
Phone: 856-389-5444