# MAHMOUD ABU-GHANAM PHYSICIAN, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669181780
- **Authorized official:** MAHMOUD ABU GHANAM MD (OWNER)
- **Authorized official phone:** (845) 707-3092

## Contact information

- **Practice address:** 1987 STATE ROUTE 52 STE 10, LIBERTY, NY 12754-8317
- **Practice address phone:** (845) 292-0078
- **Practice address fax:** (845) 292-3244
- **Mailing address:** PO BOX 190, FERNDALE, NY 12734-0190
- **Mailing address phone:** (845) 292-0078
- **Mailing address fax:** (845) 292-3244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/17/2022
- **Last updated:** 01/16/2025