MEDICARE: DR. JAWAD MANZOOR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	325024	NY
2	2084P0800X	Psychiatry Physician	25MA11583500	NJ

General Provider Information

NPI Number	:	1295354330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAWAD MANZOOR MD

Provider Business Mailing Address
First Line	:	234 E 149TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-5504
Country	:	US
Telephone Number	:	718-579-5047
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 E 149TH ST STE 9D-216
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-5504
Country	:	US
Telephone Number	:	718-579-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2020
Last Update Date	:	12/03/2025

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