ORIGIN FAMILY WELLNESS LLC NPI 1477283042

NPI Information

  • NPI: 1477283042
  • Provider Name: ORIGIN FAMILY WELLNESS LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 1811 BETHLEHEM PIKE STE A101
    FLOURTOWN, PA
    ZIP 19031
  • Phone: (215) 774-9004

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NPI Details

ORIGIN FAMILY WELLNESS LLC is a primary care clinic center in Flourtown, PA. ORIGIN FAMILY WELLNESS LLC NPI is 1477283042. The provider is registered as an organization entity type.

The provider's business location address is:

1811 BETHLEHEM PIKE STE A101
FLOURTOWN, PA
ZIP 19031-111
Phone: (215) 774-9004

The provider's authorized official is Tatiana Kisluk .
The authorized official title is Dnp and has the following contact phone number (215) 774-9004.

The enumeration date for this NPI number is 6/15/2022 and was last updated on 9/12/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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