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NPI Code Detail

MEDICARE: REDSTONE SHINE LLC

MEDICARE: REDSTONE SHINE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1720912876
Entity Type Code : Organization
Provider Name (Legal Business Name) : REDSTONE SHINE LLC
Provider Business Mailing Address
First Line : 287 WALLABOUT ST APT 4H
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-4357
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 277 COIT ST
Second Line :
City : IRVINGTON
State : NJ
Zip : 07111-4013
Country : US
Telephone Number : 347-232-2024
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ISAAC ROTTENSTEIN
Credential :
Telephone Number : 347-232-2024
Provider Enumeration Date : 06/11/2026
Last Update Date : 06/11/2026

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Directions to “REDSTONE SHINE LLC ” Practice Location

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