Origin LLC
Clinic/Center, Multi-Specialty in Willingboro, New Jersey
1124691647- Practice location
- 14 Gallaway Ln, Willingboro, NJ 08046-3226
- Phone
- 908-494-5150
- Fax
- —
- Last updated
- July 22, 2021
Origin LLC is a healthcare organization based in Willingboro, NJ. Origin LLC practices in Willingboro, NJ. The NPI Number for Origin LLC is 1124691647. The current practice location address for Origin LLC is 14 Gallaway Ln, Willingboro, NJ 08046-3226 and can be reached out via phone at 908-494-5150.
Provider Profile Details
- NPI Number
- 1124691647
- Provider Name
- Origin LLC
- Provider Entity Type
- Organization
- Address
- 14 Gallaway Ln, Willingboro, NJ 08046-3226
- Phone Number
- 908-494-5150
- Primary Taxonomy
- Clinic/Center, Multi-Specialty · 261QM1300X
- Organization Subpart
- No
- Authorized Official
- Dr. Leez-Betina Petit, DC · Founder · 908-494-5150
- Provider Enumeration Date
- July 22, 2021
- Last Update Date
- July 22, 2021
- Certification Date
- July 22, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 14 Gallaway Ln
Willingboro, NJ 08046-3226 - City
- Willingboro
- State
- New Jersey
- Zip
- 08046-3226
- Phone Number
- 908-494-5150
Provider Business Mailing Address Details
- Address
- 14 Gallaway Ln
Willingboro, NJ 08046-3226 - City
- Willingboro
- State
- NJ
- Zip
- 08046-3226
License Information
- Taxonomy
- Clinic/Center, Multi-Specialty · 261QM1300X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Origin LLC?
The NPI number of Origin LLC is 1124691647. It was assigned on July 22, 2021 and is currently active in the NPPES registry.
What is the specialty of Origin LLC?
Origin LLC is registered under the primary taxonomy Clinic/Center, Multi-Specialty (code 261QM1300X).
Where does Origin LLC practice?
The practice location is 14 Gallaway Ln, Willingboro, NJ 08046-3226. The office can be reached at 908-494-5150 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1124691647 directly on the NPPES registry website.