Healthcare Provider Details

I. General information

NPI: 1316354335
Provider Name (Legal Business Name): MELANY GAETANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1388 FORESTBROOK RD
OAKVILLE ONTARIO
L6M2H6
CA

IV. Provider business mailing address

1388 FORESTBROOK RD
OAKVILLE ONTARIO
L6M2H6
CA

V. Phone/Fax

Practice location:
  • Phone: 905-330-8950
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMTL002525
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: