Provider Demographics
NPI:1649790916
Name:ROGALSKY, TANYA YEHUDITH (RN)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:YEHUDITH
Last Name:ROGALSKY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:YEHUDITH
Other - Last Name:LANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2925A KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1805
Mailing Address - Country:US
Mailing Address - Phone:718-382-0045
Mailing Address - Fax:718-859-7157
Practice Address - Street 1:2925A KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1805
Practice Address - Country:US
Practice Address - Phone:718-382-0045
Practice Address - Fax:718-859-7157
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY630006163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse