Healthcare Provider Details

I. General information

NPI: 1669483970
Provider Name (Legal Business Name): ADVOCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5045 ROUTE 130 SUITE F
DELRAN NJ
08075-9707
US

IV. Provider business mailing address

PO BOX 71422
PHILADELPHIA PA
19176-1422
US

V. Phone/Fax

Practice location:
  • Phone: 856-461-1717
  • Fax: 856-461-1143
Mailing address:
  • Phone: 856-782-3300
  • Fax: 856-504-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DAWN M CANDIA
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 856-872-7053