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General NPI Number Information
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NPI Number | 1710502315
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Entity Type | Individual
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Provider Name | SAMANTHA LEIGH GAETANI MD
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Gender | Female
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 1111 E MCDOWELL RD BLDG A2
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City | PHOENIX
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State | AZ
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Zip | 85006-2612
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Country | US
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Telephone | 602-839-3949
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Fax |
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Provider Business Mailing Address
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Address Line | 4333 N 6TH DR APT 235
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City | PHOENIX
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State | AZ
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Zip | 85013-3193
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Country | US
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Telephone | 201-595-9990
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MT221518
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207PT0002X
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Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
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License Number | R80700
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 74471
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License Number State | AZ
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