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Organization
ARIA HEALTH PHYSICIAN SERVICES
Active
Organization
ARIA HEALTH PHYSICIAN SERVICES
Active
Other names
ARIA HEALTH PHYSICIAN SERVICES - CENTRAL SQUARE MEDICAL, Central Square Medical Center - Grant Ave
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD M. KUMOR (SENIOR VICE PRESIDENT)
(215) 612-4858
Entity
Organization
Contact information
Practice address
9501 ROOSEVELT BLVD, SUITE 206-B, PHILADELPHIA, PA 19114-1025
(215) 671-8900
(215) 671-1272
Mailing address
PO BOX 825395, PHILADELPHIA, PA 19182-5395
(215) 671-8900
(215) 671-1272
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
PA
207R00000X
Internal Medicine Physician
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200976001
KEYSTONE, IBC
PA
05
—
1007526250039
—
PA
05
—
1007526250041
—
PA
05
—
1007526250051
—
PA
01
—
10236
HEALTH PARTNERS
PA
01
—
1026492
KEYSTONE MERCY
PA
01
—
19933
AETNA
PA
01
—
379777
HIGHMARK BLUE SHIELD
PA
Enumeration date
02/22/2007
Last updated
10/12/2022
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