1942916077 NPI number — ADVOCARE , LLC

Table of content: (NPI 1942916077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942916077 NPI number — ADVOCARE , LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVOCARE , LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ADVOCARE THE PEDIATRIC GROUP
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942916077
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 ROUTE 73 N STE 320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARLTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08053-3426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-900-7229
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
281 WITHERSPOON ST STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08540-3224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-900-7229
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/23/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CANDIA
Authorized Official First Name:
DAWN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
856-389-5444

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)