Healthcare Provider Details

I. General information

NPI: 1629792353
Provider Name (Legal Business Name): KELSI BATIOJA RESIDENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2022
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S 5TH AVE
WEST READING PA
19611-2143
US

IV. Provider business mailing address

812 BARGE DR
WYOMISSING PA
19610-6812
US

V. Phone/Fax

Practice location:
  • Phone: 484-628-9797
  • Fax:
Mailing address:
  • Phone: 918-978-6412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOT023851
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: