Provider Demographics
NPI:1376955542
Name:PRYZBYLSKI, AMBER (MS, CGC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:PRYZBYLSKI
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 LAKE AVE N
Mailing Address - Street 2:A3104 PEDIGENE
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01655-0002
Mailing Address - Country:US
Mailing Address - Phone:774-442-3746
Mailing Address - Fax:774-442-3525
Practice Address - Street 1:55 LAKE AVE N
Practice Address - Street 2:A3104 PEDIGENE
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655-0002
Practice Address - Country:US
Practice Address - Phone:774-442-3746
Practice Address - Fax:774-442-3525
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAGC212170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS