Classic Medical Practice

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

CLASSIC MEDICAL PRACTICE

Practice address

540 North Ave Ste 3
Union, NJ 07083-7149

Phone

(718) 753-1721

NPI assigned

Aug 26, 2024

Last updated

Aug 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel Okoro, DNP, APN

Title

Chief Executive Office

Phone

(908) 230-2750

Specialties & licenses 4

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1255165072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 GALLOPING HILL RD",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081008",
            "telephone_number": "908-230-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 NORTH AVE STE 3",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837149",
            "telephone_number": "718-753-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC MEDICAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "OKORO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICE",
        "authorized_official_telephone_number": "908-230-2750",
        "authorized_official_credential": "DNP, APN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jevon Christmas, LPN
• Christopher Hasan Chung, D.D.S
• Almira R. Churchill
• Matthew Cirelli, DPT
• City Medical of New Jersey, PC (CityMD Urgent Care)
• Classic Wellness Family Medical Practice LLC
• Classic Wellness Family Mental Health Practice LLC
• Clear Thoughts Healthcare LLC
• Marianne Cabezas Cleary, PA-C
• Gwen Cleaves

• Multi-Specialty Clinic/Center in Union, NJ
• Providers in Union, NJ by specialty
• Multi-Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.