Provider Demographics
NPI:1114981123
Name:ARIA HEALTH PHYSICIAN SERVICES
Entity Type:Organization
Organization Name:ARIA HEALTH PHYSICIAN SERVICES
Other - Org Name:ARIA HEALTH PHYSICIAN SERVICES - BUCKS SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-612-4858
Mailing Address - Street 1:2500 MARYLAND ROAD
Mailing Address - Street 2:SUITE 504
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1226
Mailing Address - Country:US
Mailing Address - Phone:215-481-6836
Mailing Address - Fax:215-481-5788
Practice Address - Street 1:240 MIDDLETOWN BLVD STE 101D
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1832
Practice Address - Country:US
Practice Address - Phone:215-750-6010
Practice Address - Fax:215-750-6012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30001994OtherKEYSTONE MERCY
PA30022701OtherKEYSTONE MERCY
PA1007526250051Medicaid
PA2952901OtherAETNA
PA1452530OtherBLUE SHIELD
PA1452530OtherPERSONAL CHOICE
PA2031749OtherBLUE SHIELD
PA07336OtherHEALTH PARTNERS
PA2138714000OtherKEYSTONE EAST
PA=========OtherTAX ID
PA1452530OtherPERSONAL CHOICE