Healthcare Provider Details

I. General information

NPI: 1689851172
Provider Name (Legal Business Name): JEREMIAH S. REDSTONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 LINDSLEY DR STE 200
MORRISTOWN NJ
07960-4456
US

IV. Provider business mailing address

212 WARREN ST 11N
NEW YORK NY
10282-5802
US

V. Phone/Fax

Practice location:
  • Phone: 212-249-1500
  • Fax:
Mailing address:
  • Phone: 212-249-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number25MA08738100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number256024
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: