Classic Wellness Family Medical Practice Llc

LBN: Classic Wellness Family Medical Practice Llc
Classic Wellness Family Medical Practice Llc is an health care organization with primary practice located at 1220 Victor Ave , Union NJ 07083-3706. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice, Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Pain. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty. Classic Wellness Family Medical Practice Llc can be contacted via phone (718) 753-1721, or through Okoro, Daniel D via phone (718) 753-1721.

Contact Information

Primary practice address
1220 Victor Ave Union NJ 07083-3706
Phone: (718) 753-1721
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Okoro, Daniel D DNP, APN
Phone: (718) 753-1721

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 26NJ00257300 New Jersey
Allopathic & Osteopathic Physicians / General Practice 208D00000X 26NJ00257300 New Jersey
Ambulatory Health Care Facilities / Primary Care 261QP2300X 26NJ00257300 New Jersey
Ambulatory Health Care Facilities / Pain 261QP3300X 26NJ00257300 New Jersey

Profile Details

NPI number 1376950279
LBN Legal business name Classic Wellness Family Medical Practice Llc
DBA Doing business as
Authorized official Okoro, Daniel D DNP, APN
Entity Organization
Organization subpart 1 No
Enumeration date Jul 14th, 2014
Last updated Apr 27th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376950279 NPPES
New Jersey MEDICAID 0453951

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