Healthcare Provider Details

I. General information

NPI: 1114338068
Provider Name (Legal Business Name): SHANA NEELU COSHAL M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MAY ST
SOUTH ATTLEBORO MA
02703-5520
US

IV. Provider business mailing address

25 MORRISSEY BLVD UNIT 1334
BOSTON MA
02125-3361
US

V. Phone/Fax

Practice location:
  • Phone: 508-761-8500
  • Fax:
Mailing address:
  • Phone: 803-622-1264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number274274
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: