Healthcare Provider Details

I. General information

NPI: 1023621471
Provider Name (Legal Business Name): ARIA HEALTH PHYSICIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 ROOSEVELT BLVD STE 206B
PHILADELPHIA PA
19114-1027
US

IV. Provider business mailing address

PO BOX 825395
PHILADELPHIA PA
19182-5395
US

V. Phone/Fax

Practice location:
  • Phone: 215-671-8900
  • Fax: 215-671-1272
Mailing address:
  • Phone: 215-481-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

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