Healthcare Provider Details

I. General information

NPI: 1538862750
Provider Name (Legal Business Name): SUJIT KUMAR SHRESTHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 W GARDEN ST STE 105
AUBURN NY
13021-2663
US

IV. Provider business mailing address

17 LANSING ST
AUBURN NY
13021-1983
US

V. Phone/Fax

Practice location:
  • Phone: 315-253-6257
  • Fax:
Mailing address:
  • Phone: 315-255-7011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number345322
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: