Healthcare Provider Details

I. General information

NPI: 1093143406
Provider Name (Legal Business Name): ADVOCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2013
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 W RED BANK AVE SUITE 203
WOODBURY NJ
08096-1630
US

IV. Provider business mailing address

PO BOX 71422
PHILADELPHIA PA
19176-1422
US

V. Phone/Fax

Practice location:
  • Phone: 856-848-8242
  • Fax: 856-384-6015
Mailing address:
  • Phone: 856-782-3300
  • Fax: 856-504-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

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