MEDICARE: MR. ALVIN KINGCADE PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	25MP00516600	NJ

General Provider Information

NPI Number	:	1881711125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALVIN KINGCADE PA-C

Provider Business Mailing Address
First Line	:	90 BRICK RD FL 3
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-2177
Country	:	US
Telephone Number	:	856-355-6000
Fax Number	:	856-355-6731

Provider Business Practice Location Address
First Line	:	90 BRICK RD FL 3
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-2177
Country	:	US
Telephone Number	:	856-355-6000
Fax Number	:	856-355-6731

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	03/12/2026

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