Healthcare Provider Details

I. General information

NPI: 1659735330
Provider Name (Legal Business Name): SUNALI SHAH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 08/02/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 ALBANY STREET SHAPIRO 7, SUITE B
BOSTON MA
02118
US

IV. Provider business mailing address

960 MASSACHUSETTS AVE STE 2
BOSTON MA
02118-2690
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-8456
  • Fax: 617-638-8465
Mailing address:
  • Phone: 617-638-9995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number267298
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number287378
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number287378
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: