CLASSIC WELLNESS FAMILY MEDICAL PRACTICE LLC (NPI# 1376950279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376950279 |
| Entity Type | Organization |
| Organization Name | CLASSIC WELLNESS FAMILY MEDICAL PRACTICE LLC |
| Practice Address |
1220 Victor Ave Union NJ 07083-3706 |
| Practice Telephone | 7187531721 |
| Mailing Telephone | 7187531721 |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2017-04-27 |
| Authorized Official Name | DANIEL D OKORO (DOCTOR OF NURSING PRACTICE, APN) |
| Authorized Official Telephone | 7187531721 |
| Authorized Official Credential | DNP, APN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP3300X |
Clinic/Center Specialization: Pain |
26NJ00257300 | NJ | Ambulatory Health Care Facilities |
| N | 207Q00000X | Family Medicine | 26NJ00257300 | NJ | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 26NJ00257300 | NJ | Allopathic & Osteopathic Physicians |
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
26NJ00257300 | NJ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0453951 | 05 |
| Street Address |
1220 VICTOR AVE |
| City | UNION |
| State | NJ |
| Zip Code | 07083-3706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790019644 | Chinenye Okoro | Nurse Practitioner | 1220 Victor Ave, Union, NJ 07083-3706 | 2009-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811535396 | Accuview Diagnostic Services Inc | Radiology | 1620 Vauxhall Road, Suite 309, Union, NJ 07083 | 2019-12-16 |
| 1487298543 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1333 Glendale Pl, Union, NJ 07083 | 2019-11-01 |
| 1578116570 | Care Assist LLC | Home Health Aide | 2333 Morris Ave., Suite C 214, Union, NJ 07083 | 2019-07-18 |
| 1902462195 | Community Access Unlimited Inc | Community/Behavioral Health | 1 Hendricks Drive, Union, NJ 07083 | 2019-05-14 |
| 1265918577 | Francesca Viola-hamilton | Social Worker | Cooperative Counseling Services, 407 Chestnut St., Union, NJ 07083 | 2018-07-19 |
| 1891285839 | Robert E. West Jr. | Social Worker | 407 Chestnut St., Union, NJ 07083 | 2018-05-15 |
| 1861916579 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 941 945 Stuyvesant Ave, Union, NJ 07083 | 2017-08-03 |
| 1740718220 | Afnan Talat | Family Medicine | 2317 Center Island, Route 22, Union, NJ 07083 | 2017-05-30 |
| 1366976953 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2202 Halsey Street, Union, NJ 07083 | 2017-04-20 |
| 1518490275 | Sabri Youssef | Physician Assistant | 855 Lehigh Avenue, Advanced Spine Surgery Center. Suite 203, Union, NJ 07083 | 2017-04-09 |
| Find all providers in zip 07083 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1952349532 | Lifecare Family Doctors, PC | Clinic/Center | 940 Stuyvesant Ave, Suite 2, Union, NJ 07083-6906 | 2006-06-03 |
| 1275973372 | Anna Chernyak, Md LLC | Clinic/Center | 2401 Morris Ave, Union, NJ 07083-5745 | 2013-07-03 |
| 1922361054 | Union Medihealth LLC | Clinic/Center | 1050 Galloping Hill Rd Ste 204, Union, NJ 07083-7980 | 2012-06-22 |
| 1790851731 | Physician Groups Lc | Clinic/Center | 1780 Old Us Highway 50 E, Suite 102, Union, MO 63084-3330 | 2006-11-28 |
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| 1316580632 | R-health Primary Care Medical Home LLC | Clinic/Center | 2 Cooper St, Camden, NJ 08102-2348 | 2019-10-18 |
| 1881247054 | Priority Health and Wellness of Montvale, LLC | Clinic/Center | 136 Summit Ave Ste 102, Montvale, NJ 07645-1720 | 2019-07-17 |
| 1124586326 | Newmed Mua LLC | Clinic/Center | 831 Main Ave Ste 5a, Passaic, NJ 07055-8400 | 2019-03-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.