MEDICARE: BRIELLE QUARLES CNM, WHNP-BC

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	363LW0102X	Women's Health Nurse Practitioner	421912	NY
2	367A00000X	Advanced Practice Midwife	002424	NY

General Provider Information

NPI Number	:	1194682005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIELLE QUARLES CNM, WHNP-BC

Provider Business Mailing Address
First Line	:	36 STEVENS ST
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06519-1002
Country	:	US
Telephone Number	:	703-434-1788
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 E 149TH ST STE 5A
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-5504
Country	:	US
Telephone Number	:	718-579-5371
Fax Number	:

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

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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