Provider Demographics
NPI:1942368063
Name:WATOREK, KAZIMIERZ M (MD)
Entity Type:Individual
Prefix:
First Name:KAZIMIERZ
Middle Name:M
Last Name:WATOREK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 AMY CIR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1257
Mailing Address - Country:US
Mailing Address - Phone:215-504-4640
Mailing Address - Fax:215-504-4640
Practice Address - Street 1:501 BATH RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-3101
Practice Address - Country:US
Practice Address - Phone:215-785-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070943L2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine