Provider Demographics
NPI:1285767202
Name:SHOJI, TORU (MD)
Entity type:Individual
Prefix:DR
First Name:TORU
Middle Name:
Last Name:SHOJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 ELDERSLIE LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-1038
Mailing Address - Country:US
Mailing Address - Phone:203-393-1730
Mailing Address - Fax:203-393-1671
Practice Address - Street 1:2 N PLANDOME RD
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-3443
Practice Address - Country:US
Practice Address - Phone:516-944-3882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038366207ZD0900X
RI9378207ZD0900X
HI8430207ZD0900X
NY208418207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology