Organization
ADVOCARE, LLC
Active
Parent organization
ADVOCARE, LLC
Other names
Advocare West Deptford Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVOCARE, LLC
Authorized official
DAWN M CANDIA (DIRECTOR, CREDENTIALING)
(856) 872-7053
Entity
Organization
Contact information
Practice address
646 KINGS HWY, WEST DEPTFORD, NJ 08096-3145
(856) 879-2887
(856) 879-2855
Mailing address
401 ROUTE 73 N STE 320, MARLTON, NJ 08053-3426
(856) 782-3300
(856) 504-8029
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31D0901275
CLIA
—
01
—
31D0953106
CLIA
—
05
—
8245908
—
NJ
Enumeration date
08/14/2006
Last updated
11/19/2021
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