Provider Demographics
NPI:1013291301
Name:ROGOYSKI, BRANDIE SUE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDIE
Middle Name:SUE
Last Name:ROGOYSKI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CABOOSE CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHILI
Mailing Address - State:NY
Mailing Address - Zip Code:14514-9710
Mailing Address - Country:US
Mailing Address - Phone:585-802-2939
Mailing Address - Fax:
Practice Address - Street 1:2-6 TRIGON PARK
Practice Address - Street 2:
Practice Address - City:LEROY
Practice Address - State:NY
Practice Address - Zip Code:14482
Practice Address - Country:US
Practice Address - Phone:585-768-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016760-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist