Active NPI
Christina Chunlan Park, L.AC
- Acupuncturist
- North Brunswick, NJ
National Provider Identifier
1891946463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 24MZ00054700
- Practice address
- 525 Milltown Rd Ste 201
North Brunswick, NJ 08902-3317 - Phone
- (732) 545-3300
- NPI assigned
- Oct 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 002884-1 | NY | |
| Acupuncturist | 171100000X | 24MZ00054700 | NJ | Primary |
Addresses
Primary practice location
525 Milltown Rd Ste 201
North Brunswick, NJ 08902-3317
Mailing address
102 Conover Rd
Princeton Junction, NJ 08550-3230
Phone (212) 748-9123
Other names 1
- Chunlan Jin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24MZ00054700 | NJ | MD | Acupuncturist |
| 002884-1 | NY | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back to Wellness Chiropractic, LLC | Acupuncturist | Current | Accepting new patients |
| Radical Physical Therapy LLC | Past | Accepting new patients |
Locations
525 Milltown Rd
Ste 201
North Brunswick, NJ 08902
Phone (732) 545-3300
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Edison, NJ
- NPI 1659980464
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1891946463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 CONOVER RD",
"city": "PRINCETON JUNCTION",
"state": "NJ",
"postal_code": "085503230",
"telephone_number": "212-748-9123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 MILLTOWN RD STE 201",
"city": "NORTH BRUNSWICK",
"state": "NJ",
"postal_code": "089023317",
"telephone_number": "732-545-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "CHRISTINA",
"middle_name": "CHUNLAN",
"credential": "L.AC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-01",
"last_updated": "2024-04-17",
"certification_date": "2024-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "002884-1",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NJ",
"license": "24MZ00054700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHUNLAN",
"last_name": "JIN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in North Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.