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General NPI Number Information
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NPI Number | 1639501901
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Entity Type | Organization
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Legal Business Name | ADVOCARE, LLC
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 484 LAFAYETTE AVE
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City | HAWTHORNE
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State | NJ
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Zip | 07506-2522
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Country | US
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Telephone | 973-423-4770
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Fax | 973-423-4816
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Provider Business Mailing Address
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Address Line | PO BOX 3001
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City | VOORHEES
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State | NJ
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Zip | 08043-0598
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Country | US
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Telephone | 856-782-3300
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN/CEO
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Name | DR. JOHN M TEDESCHI
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Credential | M.D.
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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