MEDICARE: ALYSSA MICHELLE PIOGGIA PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	15772	MN
2	363A00000X	Physician Assistant	006742	CT

General Provider Information

NPI Number	:	1063254985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA MICHELLE PIOGGIA PA-C

Provider Business Mailing Address
First Line	:	PO BOX 860912
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55486-0912
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	881 LAFAYETTE BLVD UNIT 5H
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06604-4724
Country	:	US
Telephone Number	:	781-879-5650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2024
Last Update Date	:	06/09/2026

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