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General NPI Number Information
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NPI Number | 1699608091
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Entity Type | Organization
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Legal Business Name | SHORELINE PSYCHIATRY PC
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 385 BROADWAY STE 203
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City | REVERE
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State | MA
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Zip | 02151-3049
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Country | US
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Telephone | 443-353-9263
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Fax |
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Provider Business Mailing Address
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Address Line | 49 BURNET HILL RD
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City | LIVINGSTON
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State | NJ
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Zip | 07039-3606
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Country | US
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Telephone | 443-353-9263
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Fax | 601-429-1356
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | FRANK MICHAEL COPELI
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Credential | MD
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Telephone | 443-353-9263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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