Healthcare Provider Details

I. General information

NPI: 1114981123
Provider Name (Legal Business Name): ARIA HEALTH PHYSICIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 06/25/2020
Certification Date: 06/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 MIDDLETOWN BLVD STE 101D
LANGHORNE PA
19047-1832
US

IV. Provider business mailing address

2500 MARYLAND ROAD SUITE 504
WILLOW GROVE PA
19090-1226
US

V. Phone/Fax

Practice location:
  • Phone: 215-750-6010
  • Fax: 215-750-6012
Mailing address:
  • Phone: 215-481-6836
  • Fax: 215-481-5788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: RONALD KUMOR
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 215-612-4858