Provider Demographics
NPI:1538321591
Name:MANJOO, QURASHIA (MD)
Entity Type:Individual
Prefix:
First Name:QURASHIA
Middle Name:
Last Name:MANJOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 QUAKER VILLAGE SHOPPING CENTER
Mailing Address - Street 2:STE 2A OHIO RIVER BLVD
Mailing Address - City:LEETSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15056
Mailing Address - Country:US
Mailing Address - Phone:412-773-4663
Mailing Address - Fax:412-749-6787
Practice Address - Street 1:12 QUAKER VILLAGE SHOPPING CENTER
Practice Address - Street 2:STE 2A OHIO RIVER BLVD
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143
Practice Address - Country:US
Practice Address - Phone:724-773-4663
Practice Address - Fax:412-749-6787
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035818E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021827470001Medicaid
PA129582LCKMedicare PIN