Healthcare Provider Details

I. General information

NPI: 1073478327
Provider Name (Legal Business Name): BRIANA NICOLE HARSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 W 1ST ST
OSWEGO NY
13126-2045
US

IV. Provider business mailing address

159 W 1ST ST
OSWEGO NY
13126-2045
US

V. Phone/Fax

Practice location:
  • Phone: 315-342-9575
  • Fax:
Mailing address:
  • Phone: 315-342-9575
  • Fax: 315-342-7664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1984281251
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number19013491400292269432
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: