Healthcare Provider Details

I. General information

NPI: 1891747549
Provider Name (Legal Business Name): JENNIFER ELIZABETH REDMOND D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 01/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EASTERN AVE 2ND FLOOR EAST
SOMERVILLE NJ
08876-2552
US

IV. Provider business mailing address

27 ANDERSON ST APT A
RARITAN NJ
08869-1818
US

V. Phone/Fax

Practice location:
  • Phone: 908-300-8800
  • Fax:
Mailing address:
  • Phone: 908-300-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00625200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: