Provider Demographics
NPI:1134184468
Name:ARIA HEALTH PHYSICIAN SERVICES-SURGERY
Entity type:Organization
Organization Name:ARIA HEALTH PHYSICIAN SERVICES-SURGERY
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:ARIA HEALTH PHYSICIAN SERVICES
Mailing Address - Street 2:P. O. BOX 8500 - 6335
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-6335
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
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:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-632-3630
Practice Address - Fax:215-632-3544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA208C00000X, 2086S0102X
208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007526250041Medicaid
PA1783156OtherBLUE SHIELD
PA36045OtherHEALTH PARTNERS
PA1007526250039Medicaid
PA30027496OtherKEYSTONE MERCY
PA37353OtherHEALTH PARTNERS
PA1145598OtherAETNA
PA1413853OtherHIGHMARK BLUE SHIELD
PA1007526250051Medicaid
PA1783156OtherPERSONAL CHOICE
PA01749OtherHEALTH PARTNERS
PA2101721000OtherKEYSTONE, IBC
PA2620890000OtherKEYSTONE EAST
PA2952901OtherAETNA
PA03770OtherHEALTH PARTNERS
PA30001994OtherKEYSTONE MERCY
PA2101721000OtherKEYSTONE, IBC