Healthcare Provider Details

I. General information

NPI: 1942639141
Provider Name (Legal Business Name): INADVANCE MEDICINE ASSOCIATES EAST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 NORTHFIELD AVENUE SUITE 200
WEST ORANGE NJ
07052-5335
US

IV. Provider business mailing address

4343 EAST OUTLIER BLVD. SUITE 100W
PHOENIX AZ
85008-6507
US

V. Phone/Fax

Practice location:
  • Phone: 877-358-8648
  • Fax: 877-877-6875
Mailing address:
  • Phone: 877-358-8648
  • Fax: 877-877-6875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: JUANA SLACK
Title or Position: MEDICAL BILLING SPECIALIST
Credential:
Phone: 480-646-9086