Healthcare Provider Details

I. General information

NPI: 1457278541
Provider Name (Legal Business Name): KIRSTIN N CONNOR DACM, L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 MEMORIAL DR
ASBURY PARK NJ
07712-5028
US

IV. Provider business mailing address

67 ALBERT CUCCI DR
BRICK NJ
08724-3429
US

V. Phone/Fax

Practice location:
  • Phone: 732-512-8031
  • Fax:
Mailing address:
  • Phone: 732-512-8031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00183100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: