Provider Demographics
NPI:1396709317
Name:ARIA HEALTH PHYSICIAN SERVICES
Entity type:Organization
Organization Name:ARIA HEALTH PHYSICIAN SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALS
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-481-6873
Mailing Address - Street 1:PO BOX 825395
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-5395
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8345
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:SUITE 214
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-5050
Practice Address - Fax:215-612-5214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3416861OtherAETNA
PA10075262500041Medicaid
PA1007526250051Medicaid
PA1544426OtherBLUE SHIELD
PA10075262650039Medicaid
PA1544426OtherPERSONAL CHOICE
PA2228685000OtherKEYSTONE EAST
PA34517OtherHEALTH PARTNERS
PA30009248OtherKEYSTONE MERCY
PA=========OtherTAX ID
PA1544426OtherPERSONAL CHOICE