Irina Kan, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MZ00163700 Issued in NJ

Practice address

39 S Fullerton Ave Ste 1
Montclair, NJ 07042-6303

Phone

(201) 622-6289

Fax

(973) 680-4875

NPI assigned

Jan 8, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pilates Advantage Physical Therapy

  • Physical Therapy Clinic/Center
  • Montclair, NJ
  • NPI 1134856396
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1043080260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 S FULLERTON AVE STE 1",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070426303",
            "telephone_number": "201-622-6289",
            "fax_number": "973-680-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 S FULLERTON AVE STE 1",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070426303",
            "telephone_number": "201-622-6289",
            "fax_number": "973-680-4875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAN",
        "first_name": "IRINA",
        "credential": "L.AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00163700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kairos Psychotherapy & Wellness LLC
• Parul Kakar, MD
• Amos Kamil, LCSW
• Christina M Kamilaris, RDN, CDN, CSSD, MS
• Janne Kaminski, PT
• Abigail S Kane, PH.D.
• Aliza Kaplan
• Wendy C Kaplan, LCSW
• Ilija Karafiloski, APRN
• Sarah L Karl, PH.D.

• Acupuncturist in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Acupuncturist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.