Provider Demographics
NPI:1831455914
Name:FELARCA, LOURDES C (MD)
Entity type:Individual
Prefix:DR
First Name:LOURDES
Middle Name:C
Last Name:FELARCA
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 1:126 IRVING ST
Mailing Address - Street 2:APT 2
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-3329
Mailing Address - Country:US
Mailing Address - Phone:201-217-0102
Mailing Address - Fax:
Practice Address - Street 1:126 IRVING ST
Practice Address - Street 2:APT 2
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-3329
Practice Address - Country:US
Practice Address - Phone:201-217-0102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123537208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics