Provider Demographics
NPI:1992822936
Name:FELIKSIK-WATOREK, ELZBIETA BARBARA (MD)
Entity Type:Individual
Prefix:
First Name:ELZBIETA
Middle Name:BARBARA
Last Name:FELIKSIK-WATOREK
Suffix:
Gender:F
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:
Practice Address - Street 1:3131 PRINCETON PIKE STE 112
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2201
Practice Address - Country:US
Practice Address - Phone:609-896-2922
Practice Address - Fax:609-896-2502
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07364000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8899207Medicaid