Provider Demographics
NPI:1609901560
Name:ARIA HEALTH PHYSICIAN SERVICES
Entity Type:Organization
Organization Name:ARIA HEALTH PHYSICIAN SERVICES
Other - Org Name:NORTHEAST SURGICAL ASSOCIATES AT TORRESDALE
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:215-481-6836
Mailing Address - Fax:215-481-5788
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:SUITE 235
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1445
Practice Address - Country:US
Practice Address - Phone:215-612-5001
Practice Address - Fax:215-612-5116
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
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1640886OtherPERSONAL CHOICE
PA2315841000OtherKEYSTONE, IBC
PA1007526250041Medicaid
PA30001994OtherKEYSTONE MERCY
PA1007526250051Medicaid
PA1007526250039Medicaid
PA1640886OtherHIGHMARK BLUE SHIELD
PA34799OtherHEALTH PARTNERS
PA1640886OtherAETNA PPO
PA2678868OtherAETNA HMO
PACC4831OtherRAILROAD MEDICARE
PACC4831OtherRAILROAD MEDICARE
PA1640886OtherPERSONAL CHOICE