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General NPI Number Information
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NPI Number | 1073785655
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Entity Type | Organization
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Legal Business Name | ADVOCARE
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Dates
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Enumeration Date | 03/24/2008
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 979 N BLACK HORSE PIKE
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-1044
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Country | US
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Telephone | 856-629-5151
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Fax | 856-504-8029
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Provider Business Mailing Address
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Address Line | 1020 LAUREL OAK RD SUITE 201
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City | VOORHEES
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State | NJ
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Zip | 08043-3518
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Country | US
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Telephone | 856-782-3300
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Fax | 856-504-8029
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Authorized Official
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Title or Position | CEO/ CHAIRMAN
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Name | DR. JOHN M. TEDESCHI
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Credential | MD
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Telephone | 856-782-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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