Organization
WESTSIDE PEDIATRICS,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEON BAUTISTA MESINA (SECRETARY)
(201) 432-0714
Entity
Organization
Contact information
Practice address
2749 JOHN F KENNEDY BLVD, JERSEY CITY, NJ 07306-5540
(201) 432-0714
Mailing address
2749 JOHN F KENNEDY BLVD, JERSEY CITY, NJ 07306-5540
(201) 432-0714
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA060925
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6186106
—
NJ
05
—
6186301
—
NJ
05
—
6224903
—
NJ
Enumeration date
12/14/2006
Last updated
08/22/2020
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