Kyungjin Park, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MZ00119900 Issued in NJ

Practice address

215 Old Hook Rd Ste 3C
Westwood, NJ 07675-3173

Phone

(201) 383-9833

Fax

(201) 383-9263

NPI assigned

Aug 7, 2018

Last updated

Sep 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1568941003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 DIMAS CT",
            "city": "HARRINGTON PARK",
            "state": "NJ",
            "postal_code": "076401604",
            "telephone_number": "201-446-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 OLD HOOK RD STE 3C",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753173",
            "telephone_number": "201-383-9833",
            "fax_number": "201-383-9263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 Dimas Ct",
            "address_purpose": "LOCATION",
            "city": "Harrington Park",
            "state": "NJ",
            "postal_code": "076401604",
            "country_code": "US",
            "telephone_number": "201-446-3166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "KYUNGJIN",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00119900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Westwood",
            "affiliation": "N",
            "address_1": "215 Old Hook Rd Ste 3C",
            "city": "Westwood",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076753173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brianna Page, LPN
• Pauleena Pal, PHARMD
• Danielle Panarello, LCSW
• Cheong Park, LSW
• Esther Park
• Mark Park, DMD, MD
• Pascack Community Services (lillian booth dialysis center)
• Pascack Community Services, Inc. (Preventive Medicine Institute)
• Pascack Emergency Services Inc
• Pascack Hospital Physicians Services, P.a.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.