MEDICARE: ANNA ARDIZZONI MMS, 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	PA101582	MA

General Provider Information

NPI Number	:	1598534356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA ARDIZZONI MMS, PA-C

Provider Business Mailing Address
First Line	:	41 MALL RD
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01805-0001
Country	:	US
Telephone Number	:	781-744-3839
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 MALL RD
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01805-0001
Country	:	US
Telephone Number	:	781-744-3839
Fax Number	:

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

Provider Enumeration Date	:	12/21/2023
Last Update Date	:	02/24/2026

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