MEDICARE: MS. KATHLEEN BARNES M.S., C.G.C.

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	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1295710333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN BARNES M.S., C.G.C.

Provider Business Mailing Address
First Line	:	90 BERGEN ST
Second Line	:	SUITE 5400
City	:	NEWARK
State	:	NJ
Zip	:	07103-2425
Country	:	US
Telephone Number	:	973-972-1241
Fax Number	:	973-972-3310

Provider Business Practice Location Address
First Line	:	90 BERGEN ST
Second Line	:	SUITE 5400
City	:	NEWARK
State	:	NJ
Zip	:	07103-2425
Country	:	US
Telephone Number	:	973-972-1241
Fax Number	:	973-972-3310

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	03/15/2010

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