Healthcare Provider Details
I. General information
NPI: 1780968446
Provider Name (Legal Business Name): ADVOCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2011
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
261 JAMES ST SUITE 1G
MORRISTOWN NJ
07960-6392
US
IV. Provider business mailing address
PO BOX 71422
PHILADELPHIA PA
19176-1422
US
V. Phone/Fax
- Phone: 973-540-9393
- Fax: 973-540-1937
- Phone: 856-872-7055
- Fax: 856-504-8029
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: DR.
JOHN
M
TEDESCHI
Title or Position: CEO/CHAIRMAN
Credential: MD
Phone: 856-782-3300