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NPI Code Detail

MEDICARE: SHANA NEELU COSHAL M.D., M.P.H.

MEDICARE: SHANA NEELU COSHAL M.D., M.P.H.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician274274MA

General Provider Information

NPI Number : 1114338068
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANA NEELU COSHAL M.D., M.P.H.
Provider Business Mailing Address
First Line : 25 MORRISSEY BLVD UNIT 1334
Second Line :
City : BOSTON
State : MA
Zip : 02125-3361
Country : US
Telephone Number : 803-622-1264
Fax Number :
Provider Business Practice Location Address
First Line : 200 MAY ST
Second Line :
City : SOUTH ATTLEBORO
State : MA
Zip : 02703-5520
Country : US
Telephone Number : 508-761-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2014
Last Update Date : 11/12/2025

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