MEDICARE: SAMANTHA GRACE GASTALDO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN.468853	OH

General Provider Information

NPI Number	:	1902764392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA GRACE GASTALDO

Provider Business Mailing Address
First Line	:	PO BOX 7527
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-0727
Country	:	US
Telephone Number	:
Fax Number	:	614-544-6370

Provider Business Practice Location Address
First Line	:	111 S GRANT AVE FL 3
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-4701
Country	:	US
Telephone Number	:	614-566-9871
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “ SAMANTHA GRACE GASTALDO ” Practice Location

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