BREANNA DOMINIQUE MESA (NPI# 1720648728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720648728 |
| Entity Type | Individual |
| Full Name | BREANNA DOMINIQUE MESA |
| Credential | PA-C |
| Practice Address |
127 Montgomery St Jersey City NJ 07302-3616 |
| Mailing Address |
72 Allen Dr Wayne NJ 07470-3371 |
| Practice Telephone | 2014317200 |
| Mailing Telephone | 9739348686 |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2019-06-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 72 Allen Dr, Wayne, NJ 074703371 | 9739348686 |
| Street Address |
127 MONTGOMERY ST |
| City | JERSEY CITY |
| State | NJ |
| Zip Code | 07302-3616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083691752 | Harbor Medical Imaging, LLC | Radiology | 127 Montgomery St, Jersey City, NJ 07302-3616 | 2005-12-23 |
| 1740649268 | Vmg Jersey City | Internal Medicine | 127 Montgomery St, Jersey City, NJ 07302-3616 | 2016-02-11 |
| 1982098349 | Nithya Setty-shah | Family Medicine | 127 Montgomery St, Jersey City, NJ 07302 | 2015-03-24 |
| 1811305410 | Cara Jacobs | Physician Assistant | 127 Montgomery St, Jersey City, NJ 07302-3616 | 2014-07-27 |
| 1811009657 | Sally A. Mravcak | Family Medicine | 127 Montgomery St, Jersey City, NJ 07302-3616 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518573641 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 396-420 Luis Munoz Marin Blvd., Jersey City, NJ 07302 | 2020-09-23 |
| 1679192728 | Alejo Terrence Degawan Tabur | Student in an Organized Health Care Education/Training Program | Jersey City Medical Center, 355 Grand Street, Jersey City, NJ 07302 | 2020-04-09 |
| 1982263224 | Yasir Rafique Rajwana | Student in an Organized Health Care Education/Training Program | Jersey City Medical Center, 355 - Grand Street, Jersey City, NJ 07302 | 2019-06-11 |
| 1821653866 | Flear Vaknin | Student in an Organized Health Care Education/Training Program | Jersey City Medical Center - Obgyn, 355 Grand Street, Jersey City, NJ 07302 | 2019-05-06 |
| 1497218044 | Wolf Performance Consulting LLC | Clinic/Center | 150 Bay Street 2nd Floor - Commercial Entrance, Located Inside of 150 Bay Crossfit, Jersey City, NJ 07302 | 2019-04-10 |
| 1841769734 | Jazmin Maria Del Salto | Psychologist | 395 Grand St., Jersey City, NJ 07302 | 2018-11-20 |
| 1376024075 | Rwj Barnabashealth - Jersey City Medical Center | Psychiatric Unit | 1805 Jfk Blvd, Jersey City, NJ 07302 | 2018-08-22 |
| 1134615123 | Judith Roman | Dentist | 349 2nd St Ste B2, Jersey City, NJ 07302 | 2018-07-03 |
| 1144724873 | Banan Mohammad | Chiropractor | 190 Christopher Columbus Dr # 5c, Jersey City, NJ 07302 | 2018-03-19 |
| 1477062347 | Kingsley Ogigi Oyem | Nurse Practitioner | Rwjbarnabas Health, Jersey City Medical Center, 355 Grand Street, Jersey City, NJ 07302 | 2017-09-23 |
| Find all providers in zip 07302 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750567772 | Charles Mensah Fosuhene | Physician Assistant | 403 Pacific Ave, Jersey City, NJ 07304-3715 | 2008-01-22 |
| 1194912238 | John Su | Physician Assistant | 30 Hudson St, Jersey City, NJ 07302-4600 | 2007-10-03 |
| 1417996901 | Charles Chandler | Physician Assistant | 150 Bay St, Suite 915, Jersey City, NJ 07302-2900 | 2006-06-06 |
| 1144607144 | Mary Hannah Farish-williford | Physician Assistant | 550 Newark Ave, Suite 307, Jersey City, NJ 07306-1326 | 2015-04-29 |
| 1063722452 | Nancy Zaki | Physician Assistant | 355 Grand St, Jersey City Medical Center-emergency Dept, Jersey City, NJ 07302-4321 | 2010-10-19 |
| 1437332855 | Harini Rao | Physician Assistant | 176 Palisade Ave, Jersey City, NJ 07306-1121 | 2007-12-07 |
| 1598791063 | Clc Medical Services Inc. | Physician Assistant | 150 Bay St, Suite 915, Jersey City, NJ 07302-2900 | 2006-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891300612 | Heather C. Williamson | Physician Assistant | 57 Willis Dr, West Trenton, NJ 08628 | 2020-09-09 |
| 1427660810 | Lauren Colacicco | Physician Assistant | 406 Nj-23 North, Franklin, NJ 07416 | 2020-08-18 |
| 1912525353 | Thy T Pham | Physician Assistant | 2 Capital Way Ste 407, Pennington, NJ 08534-2521 | 2020-07-13 |
| 1982226270 | Alexandra Bellisario | Physician Assistant | 7 Normandy Pl, Colts Neck, NJ 07722-1174 | 2020-05-11 |
| 1497394266 | Trevor Paul | Physician Assistant | 167 Us Highway 9 Ste 5, Englishtown, NJ 07726-9215 | 2019-12-27 |
| 1295371003 | Sujin Kim | Physician Assistant | 500 Grand Ave Ste 201, Englewood, NJ 07631-4968 | 2019-11-27 |
| 1811531767 | Kaceyanne Lynn Cerankowski | Physician Assistant | 3131 Princeton Pike Bldg 4a, Lawrenceville, NJ 08648-2201 | 2019-11-04 |
| 1760024665 | Paula Kolodynski | Physician Assistant | 355 Us Route 22, Springfield Township, NJ 07081 | 2019-10-11 |
| 1245871334 | Terrell Amanda Collins | Physician Assistant | 76 W Jimmie Leeds Rd Ste 201, Galloway, NJ 08205-9417 | 2019-10-01 |
| 1013561422 | Adrienne Lauren Rinaldi | Physician Assistant | 1400 State Highway 70, Relievus, Cherry Hill, NJ 08034-0000 | 2019-07-25 |
| Find all providers with the same taxonomy | ||||
| City | JERSEY CITY |
| Zip Code | 07302 |
Please comment or provide details below to improve the information on BREANNA DOMINIQUE MESA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.