Provider Demographics
NPI:1649478967
Name:CAMMARATA, GENNA M (DO)
Entity type:Individual
Prefix:
First Name:GENNA
Middle Name:M
Last Name:CAMMARATA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36050 N 58TH ST
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-9162
Mailing Address - Country:US
Mailing Address - Phone:856-304-3909
Mailing Address - Fax:
Practice Address - Street 1:36050 N 58TH ST
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-9162
Practice Address - Country:US
Practice Address - Phone:856-304-3909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-09
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005627207P00000X
AZFC2555982207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine