Provider Demographics
NPI:1316354335
Name:GAETANI, MELANY (MD)
Entity type:Individual
Prefix:
First Name:MELANY
Middle Name:
Last Name:GAETANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1388 FORESTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L6M2H6
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1388 FORESTBROOK RD
Practice Address - Street 2:
Practice Address - City:OAKVILLE
Practice Address - State:ONTARIO
Practice Address - Zip Code:L6M2H6
Practice Address - Country:CA
Practice Address - Phone:905-330-8950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMTL002525208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics