Provider Demographics
NPI:1659442226
Name:MANZOOR, SHOOJA (MD)
Entity type:Individual
Prefix:
First Name:SHOOJA
Middle Name:
Last Name:MANZOOR
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 1:11116 MEDICAL CAMPUS RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:575 ROUTE 28 STE 2100
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1363
Practice Address - Country:US
Practice Address - Phone:089-725-5530
Practice Address - Fax:908-253-6559
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0103513208000000X
NJ25MA121796000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics