1114981123 NPI number — ARIA HEALTH PHYSICIAN SERVICES

Table of content: (NPI 1114981123)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114981123 NPI number — ARIA HEALTH PHYSICIAN SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARIA HEALTH PHYSICIAN SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ARIA HEALTH PHYSICIAN SERVICES - BUCKS SURGERY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114981123
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2500 MARYLAND ROAD
Provider Second Line Business Mailing Address:
SUITE 504
Provider Business Mailing Address City Name:
WILLOW GROVE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19090-1226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-481-6836
Provider Business Mailing Address Fax Number:
215-481-5788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
240 MIDDLETOWN BLVD STE 101D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANGHORNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19047-1832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-750-6010
Provider Business Practice Location Address Fax Number:
215-750-6012
Provider Enumeration Date:
04/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KUMOR
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VICE PRESIDENT
Authorized Official Telephone Number:
215-612-4858

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2086X0206X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 30001994 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30022701 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007526250051 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2952901 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1452530 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1452530 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2031749 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 07336 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2138714000 . This is a "KEYSTONE EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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