Provider Demographics
NPI:1790810653
Name:ARIA HEALTH PHYSICIAN SERVICES PHYSICAL MEDICINE & REHAB
Entity Type:Organization
Organization Name:ARIA HEALTH PHYSICIAN SERVICES PHYSICAL MEDICINE & REHAB
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:215-612-4584
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:PHYSICAL MEDICINE AND REHABILITATION
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-4001
Practice Address - Fax:215-612-4584
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
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA452729OtherAETNA CONTRACT
PA570921OtherPERSONAL CHOICE
PACC4831OtherRAILROAD MEDICARE
PA1007526250039Medicaid
PA2031769OtherHIGHMARK BLUE SHIELD
PA2601329OtherAETNA
PA01738OtherHEALTH PARTNERS
PA1007526250051Medicaid
PA1007526250041Medicaid
PA570921OtherHIGHMARK BLUE SHIELD
PA0179761000OtherKEYSTONE, IBC
PA30000910OtherKEYSTONE MERCY
PA1007526250041Medicaid
PA452729OtherAETNA CONTRACT