Organization
ADVOCARE
Active
Parent organization
ADVOCARE
Other names
Advocare Medford Station Internal Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVOCARE
Authorized official
DR. JOHN M. TEDESCHI MD (CEO/ CHAIRMAN)
(856) 782-3300
Entity
Organization
Contact information
Practice address
69 N MAIN ST, MEDFORD, NJ 08055-2718
(609) 953-9000
(609) 953-9696
Mailing address
PO BOX 71422, PHILADELPHIA, PA 19176-1422
(856) 872-7055
(856) 504-8029
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31D0118747
CLIA
—
Enumeration date
08/12/2008
Last updated
09/16/2022
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