Provider Demographics
NPI:1629597034
Name:ADVOCARE, LLC
Entity Type:Organization
Organization Name:ADVOCARE, LLC
Other - Org Name:ADVOCARE TOTAL CARE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MCQUEARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-872-7052
Mailing Address - Street 1:550 NEWARK AVE STE 409
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1326
Mailing Address - Country:US
Mailing Address - Phone:201-714-7902
Mailing Address - Fax:201-795-4999
Practice Address - Street 1:550 NEWARK AVE STE 409
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1326
Practice Address - Country:US
Practice Address - Phone:201-714-7902
Practice Address - Fax:201-795-4999
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVOCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty