Individual
DR. MAHMOUD ABU GHANAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1987 STATE ROUTE 52 STE 10, LIBERTY, NY 12754-8317
(845) 292-0078
(845) 292-3244
Mailing address
PO BOX 190, FERNDALE, NY 12734-0558
(845) 292-0078
(845) 292-3244
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
272625
NY
208VP0014X
Interventional Pain Medicine Physician
Primary
272625
NY
Other
Enumeration date
05/23/2006
Last updated
11/15/2024
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