Healthcare Provider Details

I. General information

NPI: 1467754762
Provider Name (Legal Business Name): ADVOCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2010
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 WHITE HORSE PIKE
HADDON HEIGHTS NJ
08035-1705
US

IV. Provider business mailing address

PO BOX 3001
VOORHEES NJ
08043-0598
US

V. Phone/Fax

Practice location:
  • Phone: 856-547-6000
  • Fax: 856-546-3189
Mailing address:
  • Phone: 856-782-3300
  • Fax: 856-504-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN M. TEDESCHI
Title or Position: CEO/ CHAIRMAN
Credential: MD
Phone: 856-782-3300