Healthcare Provider Details

I. General information

NPI: 1609901560
Provider Name (Legal Business Name): ARIA HEALTH PHYSICIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
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 235
PHILADELPHIA PA
19114-1445
US

IV. Provider business mailing address

PO BOX 825395
PHILADELPHIA PA
19182-5395
US

V. Phone/Fax

Practice location:
  • Phone: 215-612-5001
  • Fax: 215-612-5116
Mailing address:
  • Phone: 215-481-6836
  • Fax: 215-481-5788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

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