MEDICARE: MS. KARINA BRIERLEY MS, CGC

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.)	61	CT

General Provider Information

NPI Number	:	1366058182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KARINA BRIERLEY MS, CGC

Provider Business Mailing Address
First Line	:	330 ORCHARD ST STE 107
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-4430
Country	:	US
Telephone Number	:	203-200-4362
Fax Number	:	203-200-1362

Provider Business Practice Location Address
First Line	:	330 ORCHARD ST STE 107
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-4430
Country	:	US
Telephone Number	:	203-200-4362
Fax Number	:	203-200-1362

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

Provider Enumeration Date	:	09/17/2020
Last Update Date	:	09/17/2020

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