Individual provider Active NPI

Christina Chunlan Park, L.AC

  • Acupuncturist
  • North Brunswick, NJ
National Provider Identifier
1891946463
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
24MZ00054700 Issued in NJ
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

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

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

LicenseStateTypeSpecialty
24MZ00054700NJMDAcupuncturist
002884-1NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Wellness Chiropractic, LLC Acupuncturist CurrentSince Apr 21, 2024 Accepting new patients
Radical Physical Therapy LLC PastSince Aug 2, 2020 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.

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.

Verify at the official NPI Registry.