Healthcare Provider Details
I. General information
NPI: 1265620553
Provider Name (Legal Business Name): ARIA HEALTH PHYSICIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2007
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3998 RED LION RD SUITE 301
PHILADELPHIA PA
19114-1436
US
IV. Provider business mailing address
PO BOX 825395
PHILADELPHIA PA
19182-5395
US
V. Phone/Fax
- Phone: 215-612-4884
- Fax: 215-612-4911
- Phone: 215-481-6836
- Fax: 215-481-5788
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RONALD
KUMOR
Title or Position: CEO-PRESIDENT AHPS
Credential:
Phone: 215-612-4858