Healthcare Provider Details

I. General information

NPI: 1053456079
Provider Name (Legal Business Name): ARIA HEALTH PHYSICIANS SERVICES - EMERGENCY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3998 RED LION RD EMERGENCY MEDICINE
PHILADELPHIA PA
19114-1436
US

IV. Provider business mailing address

PO BOX 825395
PHILADELPHIA PA
19182-5395
US

V. Phone/Fax

Practice location:
  • Phone: 215-612-4963
  • Fax: 215-612-4532
Mailing address:
  • Phone: 215-807-8000
  • Fax: 215-612-4532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: MARY M. FINN
Title or Position: VICE PRESIDENT OF FINANCE
Credential:
Phone: 215-710-3757