Healthcare Provider Details

I. General information

NPI: 1255130662
Provider Name (Legal Business Name): SOWNTHARYA ARTHI AYYAPPAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 GREENWOOD LN
ACTON MA
01720-3902
US

IV. Provider business mailing address

2 GREENWOOD LN
ACTON MA
01720-3902
US

V. Phone/Fax

Practice location:
  • Phone: 978-427-9694
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number3021552
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: