Advocare, LLC

Organization Active NPI Pediatrics Physician · Medford, NJ

NPI 1659383602 · NPPES record last updated Aug 26, 2014

Key facts

NPI
1659383602
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
ADVOCARE, LLC
Practice address
520 Stokes Rd
BLDG. B10
Medford, NJ 08055-2904
Phone
(609) 654-9112
Fax
(609) 654-7404
NPI assigned
Aug 11, 2006
Organization subpart
Yes
Parent organization (as reported)
ADVOCARE, LLC

Authorized official

Name
Dr. John M Tedeschi, M.D.
Title
Ceo/Chairman
Phone
(856) 782-3300

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Advocare Chalfont Internal Medicine (248 organizations share this tax ID)
Part of
Advocare Chalfont Internal Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208000000X Yes
Pediatric Adolescent Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2080A0000X

Addresses

Primary practice location

520 Stokes Rd
BLDG. B10
Medford, NJ 08055-2904

Mailing address

PO Box 3001
Voorhees, NJ 08043-0598
Phone (856) 782-3300

Other identifiers

IdentifierTypeStateIssuer
31D1105569OtherADVOCARE MEDFORD PEDIATRIC AND ADOLESCENT MEDICINE- CLIA
31D0118785OtherADVOCARE MEDFORD PEDIATRIC AND ADOLESCENT MEDICINE- CLIA

Other names

  • Advocare Medford Peds & Adolescent Med Doing business as

Other providers in Medford, NJ

All providers in Medford, NJ · Pediatrics Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.