| Classic Wellness Family Medical Practice Llc | |
|
1220 Victor Ave Union NJ 07083-3706 | |
| (718) 753-1721 | |
| Not Available |
| Full Name | Classic Wellness Family Medical Practice Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1220 Victor Ave, Union, New Jersey |
| Authorized Official Name and Position | Daniel D Okoro (DOCTOR OF NURSING PRACTICE, APN) |
| Authorized Official Contact | 7187531721 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Classic Wellness Family Medical Practice Llc 1220 Victor Ave Union NJ 07083-3706 Ph: (718) 753-1721 | Classic Wellness Family Medical Practice Llc 1220 Victor Ave Union NJ 07083-3706 Ph: (718) 753-1721 |
| NPI Number | 1376950279 |
|---|---|
| Provider Enumeration Date | 07/14/2014 |
| Last Update Date | 04/27/2017 |
| Medicare PECOS PAC ID | 3274804240 |
|---|---|
| Medicare Enrollment ID | O20170809002627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376950279 | NPI | - | NPPES |
| 0453951 | Medicaid | NJ |
| Provider Name | Daniel D Okoro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023325172 PECOS PAC ID: 9234391533 Enrollment ID: I20170809002841 |
| Provider Name | Chinenye Okoro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790019644 PECOS PAC ID: 3870635881 Enrollment ID: I20170810000082 |
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