Provider Demographics
NPI:1508991589
Name:ARIA HEALTH PHYSICIAN SERVICES - JUNIATA
Entity Type:Organization
Organization Name:ARIA HEALTH PHYSICIAN SERVICES - JUNIATA
Other - Org Name:JUNIATA FAMILY MEDICAL
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: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:215-537-5096
Practice Address - Street 1:1139 E LUZERNE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-5234
Practice Address - Country:US
Practice Address - Phone:215-537-5094
Practice Address - Fax:215-537-5096
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
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11055OtherHEALTH PARTNERS
PA1007526250039Medicaid
PA381501OtherHIGHMARK BLUE SHIELD
PA1007526250041Medicaid
PA1007526250051Medicaid
PA2010OtherAETNA
PA381501OtherPERSONAL CHOICE
PA0422923001OtherKEYSTONE, IBC
PA1022049OtherKEYSTONE MERCY
PA1007526250039Medicaid
PA2010OtherAETNA