Healthcare Provider Details

I. General information

NPI: 1023999620
Provider Name (Legal Business Name): ONSITE PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 BLACK WALNUT DR
MOUNTAIN TOP PA
18707-1566
US

IV. Provider business mailing address

439 BLACK WALNUT DR
MOUNTAIN TOP PA
18707-1566
US

V. Phone/Fax

Practice location:
  • Phone: 704-258-9530
  • Fax:
Mailing address:
  • Phone: 570-285-5228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KASHIF ABDULLAH KHAN
Title or Position: MD/OWNER
Credential: MD
Phone: 570-285-5228