Healthcare Provider Details

I. General information

NPI: 1467868208
Provider Name (Legal Business Name): ADVOCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MADISON AVE STE 201 3RD FLOOR
MADISON NJ
07940-1868
US

IV. Provider business mailing address

PO BOX 3001
VOORHEES NJ
08043-0598
US

V. Phone/Fax

Practice location:
  • Phone: 973-822-2772
  • Fax: 973-822-2773
Mailing address:
  • Phone: 856-782-3300
  • Fax: 856-504-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

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