Healthcare Provider Details

I. General information

NPI: 1437984911
Provider Name (Legal Business Name): MONICA ASAL MOUSSAVIAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

582 MIDDLETOWN BLVD STE B90
LANGHORNE PA
19047-1959
US

IV. Provider business mailing address

8501 ARLINGTON BLVD STE 500
FAIRFAX VA
22031-4631
US

V. Phone/Fax

Practice location:
  • Phone: 702-661-4887
  • Fax:
Mailing address:
  • Phone: 877-975-7744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: