Healthcare Provider Details
I. General information
NPI: 1194682005
Provider Name (Legal Business Name): BRIELLE QUARLES CNM, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
234 E 149TH ST STE 5A
BRONX NY
10451-5504
US
IV. Provider business mailing address
36 STEVENS ST
NEW HAVEN CT
06519-1002
US
V. Phone/Fax
- Phone: 718-579-5371
- Fax:
- Phone: 703-434-1788
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | 421912 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | 002424 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: