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General NPI Number Information
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NPI Number | 1770538696
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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 | 05/23/2006
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Last Update Date | 11/22/2021
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Provider Practice Location Address
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Address Line | 401 ROUTE 73 N STE 320
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City | MARLTON
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State | NJ
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Zip | 08053-3426
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Country | US
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Telephone | 856-872-7055
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Fax |
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Provider Business Mailing Address
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Address Line | 401 ROUTE 73 N STE 320
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City | MARLTON
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State | NJ
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Zip | 08053-3426
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Country | US
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Telephone | 856-872-7055
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | DAWN M CANDIA
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Credential |
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Telephone | 856-872-7053
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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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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080P0008X
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Taxonomy Name | Pediatric Neurodevelopmental Disabilities Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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