Healthcare Provider Details

I. General information

NPI: 1083403117
Provider Name (Legal Business Name): AIMI SHRESTHA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date: 03/02/2026
Reactivation Date: 04/01/2026

III. Provider practice location address

100 N ACADEMY AVE
DANVILLE PA
17822-0001
US

IV. Provider business mailing address

475 SEAVIEW AVENUE
STATEN ISLAND NY
10305
US

V. Phone/Fax

Practice location:
  • Phone: 718-226-8630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: