Provider Demographics
NPI:1053587998
Name:SEARES, JESSICA BAUTISTA (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:BAUTISTA
Last Name:SEARES
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 1:35 BEAVERSON BLVD BLDG 7
Mailing Address - Street 2:SUITE B
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7812
Mailing Address - Country:US
Mailing Address - Phone:732-262-2400
Mailing Address - Fax:732-262-3883
Practice Address - Street 1:35 BEAVERSON BLVD BLDG 7
Practice Address - Street 2:SUITE B
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7812
Practice Address - Country:US
Practice Address - Phone:732-262-2400
Practice Address - Fax:732-262-3883
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06316400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine