Healthcare Provider Details

I. General information

NPI: 1184552614
Provider Name (Legal Business Name): SAMANTHA SCETTA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 BLACKSTONE BLVD STE 2
PROVIDENCE RI
02906-4829
US

IV. Provider business mailing address

17 JUSTICE ST
NORTH PROVIDENCE RI
02911-2009
US

V. Phone/Fax

Practice location:
  • Phone: 401-455-6200
  • Fax:
Mailing address:
  • Phone: 401-954-2315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberCLP06890
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: