Healthcare Provider Details

I. General information

NPI: 1740090117
Provider Name (Legal Business Name): SWORNIM MAN SHRESTHA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 N MAIN ST
ATTLEBORO MA
02703-2282
US

IV. Provider business mailing address

9 N MAIN ST
ATTLEBORO MA
02703-2215
US

V. Phone/Fax

Practice location:
  • Phone: 508-205-4600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA102558
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: