MEDICARE: DR. ALYSSA WILLIG OD, MS

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	152W00000X	Optometrist	OEG003144	PA

General Provider Information

NPI Number	:	1427400076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALYSSA WILLIG OD, MS

Provider Business Mailing Address
First Line	:	6921 MONROE AVE
Second Line	:
City	:	WEST MIFFLIN
State	:	PA
Zip	:	15122-2747
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 S HILLS VLG
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-1400
Country	:	US
Telephone Number	:	412-833-5675
Fax Number	:

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

Provider Enumeration Date	:	07/07/2016
Last Update Date	:	07/07/2016

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