Healthcare Provider Details

I. General information

NPI: 1619314747
Provider Name (Legal Business Name): ARIA HEALTH PHYSICIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 05/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9910 FRANKFORD AVE
PHILADELPHIA PA
19114-1900
US

IV. Provider business mailing address

10800 KNIGHTS RD
PHILADELPHIA PA
19114-4200
US

V. Phone/Fax

Practice location:
  • Phone: 215-632-2636
  • Fax:
Mailing address:
  • Phone: 215-612-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberSP012655
License Number StatePA

VIII. Authorized Official

Name: SUSAN ABRAHAM
Title or Position: PRESIDENT
Credential:
Phone: 215-612-4823