Trucare Management CT PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TRUCARE MANAGEMENT CT PC

Practice address

44 Maritime Dr
Mystic, CT 06355-1958

Phone

(212) 734-6621

NPI assigned

Oct 28, 2026

Last updated

Oct 28, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Waseem Ghannam

Title

Owner

Phone

(704) 231-4571

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1793145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793145600000",
    "number": "1356249411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 CEDARBRIDGE AVE STE 1A",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087017048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 MARITIME DR",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551958",
            "telephone_number": "212-734-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUCARE MANAGEMENT CT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-28",
        "last_updated": "2026-10-28",
        "certification_date": "2026-10-28",
        "status": "A",
        "authorized_official_last_name": "GHANNAM",
        "authorized_official_first_name": "WASEEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-231-4571"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Mystic, CT
• Providers in Mystic, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.