Healthcare Provider Details

I. General information

NPI: 1093637852
Provider Name (Legal Business Name): BRIANNA ASHLEY GIVENS-ROGALA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIANNA ROGALA

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 BALL RD APT 5
SYRACUSE NY
13215-1646
US

IV. Provider business mailing address

98 BALL RD APT 5
SYRACUSE NY
13215-1646
US

V. Phone/Fax

Practice location:
  • Phone: 315-450-4359
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN00373
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: