Provider Demographics
NPI:1215176110
Name:ADVANTAGE CARE GERIATRICS, LLC
Entity type:Organization
Organization Name:ADVANTAGE CARE GERIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:REDLING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-707-3027
Mailing Address - Street 1:168 PRESTON DR
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07933-1438
Mailing Address - Country:US
Mailing Address - Phone:732-707-3027
Mailing Address - Fax:732-707-3031
Practice Address - Street 1:156 LYONS AVE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2016
Practice Address - Country:US
Practice Address - Phone:732-707-3027
Practice Address - Fax:732-707-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05300100174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty