Provider Demographics
NPI:1760515423
Name:MCKENNA, CARRIE D (MS, CGC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:D
Last Name:MCKENNA
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:MCKENNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:GENZYME GENETICS, 833 CHESTNUT STREET
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-351-2331
Mailing Address - Fax:215-351-0586
Practice Address - Street 1:GENZYME GENETICS, 833 CHESTNUT STREET
Practice Address - Street 2:SUITE 1250
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-351-2331
Practice Address - Fax:215-351-0586
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY870620170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS