Healthcare Provider Details
I. General information
NPI: 1306492327
Provider Name (Legal Business Name): ARIA HEALTH PHYSICIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/15/2019
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5000 FRANKFORD AVE STE 1
PHILADELPHIA PA
19124-2620
US
IV. Provider business mailing address
PO BOX 825395
PHILADELPHIA PA
19182-5395
US
V. Phone/Fax
- Phone: 215-831-2218
- Fax: 215-831-2545
- Phone: 215-481-6873
- Fax: 215-481-5788
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RONALD
KUMOR
Title or Position: PRESIDENT CEO
Credential:
Phone: 215-612-4858