Individual
MITRA ASSADI-KHANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1101 CHESTNUT ST FL 10, PHILADELPHIA, PA 19107-3612
(215) 955-6000
Mailing address
901 WALNUT ST FL 4, PHILADELPHIA, PA 19107-5214
(215) 955-6000
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD061155L
PA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
C1-0013230
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0064051000
AMERIHEALTH/KEYSTONE/IBC
NJ
01
—
018376
PA BS HIGHMARK
NJ
01
—
0342325
CIGNA
NJ
01
—
1010223
HORIZON NJ HEALTH
NJ
01
—
18376
AMERIHEALTH/PPO PABS
NJ
01
—
1883383
UNITED HEALTH
NJ
01
—
20495
UNIVERSITY HEALTH PLAN
NJ
01
—
3009843
AETNA
NJ
01
—
3K5933
HEALTHNET
NJ
05
—
7712201
—
NJ
01
—
CA0000306
AMERICHOICE
NJ
01
—
HORIZON NJ HEALTH
1169152
NJ
01
—
P2182793
OXFORD
NJ
Enumeration date
10/18/2006
Last updated
10/17/2025
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