MEDICARE: MICHELLE P SARDELLA 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	:	1346433026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE P SARDELLA M.S., C.G.C.

Provider Business Mailing Address
First Line	:	3400 COMPUTER DR
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-1771
Country	:	US
Telephone Number	:	508-389-6682
Fax Number	:	508-389-5549

Provider Business Practice Location Address
First Line	:	3400 COMPUTER DR
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-1771
Country	:	US
Telephone Number	:	508-389-6682
Fax Number	:	508-389-5549

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

Provider Enumeration Date	:	08/25/2007
Last Update Date	:	08/25/2007

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