1760515423 NPI number — CARRIE D. MCKENNA MS, CGC

Table of content: CARRIE D. MCKENNA MS, CGC (NPI 1760515423)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760515423 NPI number — CARRIE D. MCKENNA MS, CGC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCKENNA
Provider First Name:
CARRIE
Provider Middle Name:
D.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, CGC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCKENNA
Provider Other First Name:
CARRIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, CGC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1760515423
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
GENZYME GENETICS, 833 CHESTNUT STREET
Provider Second Line Business Mailing Address:
SUITE 1250
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-351-2331
Provider Business Mailing Address Fax Number:
215-351-0586

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GENZYME GENETICS, 833 CHESTNUT STREET
Provider Second Line Business Practice Location Address:
SUITE 1250
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-351-2331
Provider Business Practice Location Address Fax Number:
215-351-0586
Provider Enumeration Date:
03/13/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 170300000X , with the licence number:  870620 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)