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PEDIATRICS & ADOLESCENT SAINT MARY CLINIC, LLC
NPI 1831555705
Pediatrics - Adolescent Medicine in Kearny, NJ

Active since January 08, 2016CLIA 31D2348233 · Waiver
65 KEARNY AVE, KEARNY, NJ 07032(646) 388-2111 Get Directions Write a Review

NPPES record last updated: January 8, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Pediatrics & Adolescent Saint Mary Clinic, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRICS & ADOLESCENT SAINT MARY CLINIC, LLC (NPI 1831555705) is a healthcare organization registered as an adolescent medicine in Kearny, New Jersey and active in the NPI registry since January 2016. The organization holds a CLIA Waiver certificate valid through August 2, 2028 and lists Inas Wassef, Owner, as its authorized official.

NPPES Registry Identity

NPI1831555705
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NamePEDIATRICS & ADOLESCENT SAINT MARY CLINIC, LLC
Location Address65 KEARNY AVEKearny, NJ 07032-2334
Mailing Address204 Green Valley RdStaten Island, NY 10312-1825
Phone(646) 388-2111
Organization SubpartNo
Authorized OfficialInas WassefOwner · (646) 388-2111
Enumeration DateJanuary 8, 2016
✔ NPI 1831555705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in NJ · 25MA09372400
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
65 KEARNY AVE, Kearny, NJ 07032
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2348233

Pediatrics& Adolescent St Mary Clinic, LLC · Jersey City, NJ
Active · expires Aug 2, 2028
CLIA Number31D2348233
Laboratory TypePhysician Office
Certificate Effective DateAugust 3, 2026
Certificate Expiration DateAugust 2, 2028
Laboratory DirectorInas L. Wassef
Laboratory Phone(646) 388-2111
Laboratory LocationPediatrics& Adolescent St Mary Clinic, LLC35 Journal Square Suite 825, Jersey City, NJ 07306
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. FRANCES TANG DDS
Dentist (General Practice)
65 KEARNY AVE
KEARNY, NJ 07032
Hudson County (201) 997-7201
DR. ANDREW GEORGE HANNA DMD
Dentist (General Practice)
65 KEARNY AVE
KEARNY, NJ 07032
Hudson County (201) 997-7201
DR. SONIA TAILOR DDS
Dentist (General Practice)
65 KEARNY AVE
KEARNY, NJ 07032
Hudson County (201) 997-7201
SOUHA HANNA DDS LLC
Dentist (General Practice)
65 KEARNY AVE
KEARNY, NJ 07032
Hudson County (201) 997-7201

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediatrics & Adolescent Saint Mary Clinic, LLC's NPI number?

The NPI number for Pediatrics & Adolescent Saint Mary Clinic, LLC is 1831555705. It was assigned to this organization in the NPPES registry on January 8, 2016.

Where is Pediatrics & Adolescent Saint Mary Clinic, LLC located?

Pediatrics & Adolescent Saint Mary Clinic, LLC is located at 65 Kearny Ave, Kearny, NJ 07032. The listed phone number is (646) 388-2111.

What is Pediatrics & Adolescent Saint Mary Clinic, LLC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Does Pediatrics & Adolescent Saint Mary Clinic, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2348233) is associated with this NPI, valid through August 2, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pediatrics & Adolescent Saint Mary Clinic, LLC was last updated on January 8, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.