Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRIELLE DOMINIQUE BAGOZZI
Deactivated Sole ProprietorBRIELLE DOMINIQUE BAGOZZI is a Athletic Trainer healthcare provider located in SYRACUSE, New York. NPI 1730815671 is deactivated in the NPPES registry. Verify at CMS.
Athletic Trainer · SYRACUSE, NY
This NPI has been deactivated.
The record was deactivated on September 11, 2025.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1730815671
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 25, 2022 (3.1315068493151 yrs)
- Last Updated
- Oct 6, 2025
- Deactivated
- Sep 11, 2025
- License
-
004995 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
119 LAKEWOOD PINES TRLSYRACUSE, NY, 132091161Browse NY providers · Browse ZIP 13209
- Phone
- 3154477761
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in SYRACUSE, NY
| Name | Credential | NPI |
|---|---|---|
| MR. SCOTT MICHAEL PETERSON | ATC | 1033126974 |
| MR. MICHAEL HAYDEN WILSON | ATC | 1053322214 |
| MR. TROY ALAN GERLT | MS, ATC | 1801927496 |
| MR. MATTHEW JOSEPH SWEET | MS, ATC | 1114109519 |
| MS. MARY K. BUTLAK | ATC | 1659624526 |
| ADELYN PASSARO | — | 1245638790 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.