Healthcare Provider Details

I. General information

NPI: 1124940218
Provider Name (Legal Business Name): PERSON FIRST MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 JAMES ST
SYRACUSE NY
13203-2503
US

IV. Provider business mailing address

1999 CEDARBRIDGE AVE STE 1A
LAKEWOOD NJ
08701-7048
US

V. Phone/Fax

Practice location:
  • Phone: 212-734-6621
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WASEEM GHANNAM
Title or Position: OWNER
Credential:
Phone: 212-734-6621