Provider Demographics
NPI:1083749931
Name:ARIA HEALTH PHYSICIAN SERVICES - PATHOLOGY
Entity Type:Organization
Organization Name:ARIA HEALTH PHYSICIAN SERVICES - PATHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-612-4823
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:215-612-4431
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:PATHOLOGY DEPARTMENT
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-4030
Practice Address - Fax:215-612-4431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA452729OtherAETNA CONTRACT
PA046129OtherKEYSTONE MERCY
PA1007526250041Medicaid
PA1007526250051Medicaid
PA2031753OtherHIGHMARK BLUE SHIELD
PA1007526250039Medicaid
PA0748852000OtherKEYSTONE, IBC
PA2968422OtherAETNA
PA570921OtherPERSONAL CHOICE
PA28898OtherHEALTH PARTNERS
PA570921OtherHIGHMARK BLUE SHIELD
PA2968422OtherAETNA
PA452729OtherAETNA CONTRACT