Provider Demographics
NPI:1437727666
Name:ADVOCARE NEUROLOGIC AND HEADACHE ASSOCIATES
Entity Type:Organization
Organization Name:ADVOCARE NEUROLOGIC AND HEADACHE ASSOCIATES
Other - Org Name:ADVOCARE NEUROLOGIC AND HEADACHE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CANDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-389-5444
Mailing Address - Street 1:401 ROUTE 73 N STE 320
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3426
Mailing Address - Country:US
Mailing Address - Phone:856-872-7055
Mailing Address - Fax:
Practice Address - Street 1:3070 BRISTOL PIKE
Practice Address - Street 2:BLDG 2 SUITE 124
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020
Practice Address - Country:US
Practice Address - Phone:215-245-0272
Practice Address - Fax:215-244-1005
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVOCARE , LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-14
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty