Provider Demographics
NPI:1326235441
Name:GODLEWSKA-JANUSZ, ELZBIETA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELZBIETA
Middle Name:
Last Name:GODLEWSKA-JANUSZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELZBIETA
Other - Middle Name:
Other - Last Name:GODLEWSKA-JANUSZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2177 OAK TREE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1082
Mailing Address - Country:US
Mailing Address - Phone:732-549-7007
Mailing Address - Fax:
Practice Address - Street 1:2177 OAK TREE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1082
Practice Address - Country:US
Practice Address - Phone:732-549-7007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08293300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics