Organization
ORIGIN MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIR ISSA (OWNER)
(973) 310-5497
Entity
Organization
Contact information
Practice address
401 HAMBURG TPKE STE 310, WAYNE, NJ 07470-2139
(973) 310-5497
(862) 298-0729
Mailing address
189 BERDAN AVE UNIT 171, WAYNE, NJ 07470-3233
(973) 310-5497
(862) 298-0729
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
04/02/2026
Last updated
04/02/2026
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