Provider Demographics
NPI:1508859216
Name:BRIGGS, ALICIA A (MD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:A
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 HEMMELSKAMP RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-2106
Mailing Address - Country:US
Mailing Address - Phone:310-592-0609
Mailing Address - Fax:
Practice Address - Street 1:24 STEVENS ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3852
Practice Address - Country:US
Practice Address - Phone:203-852-2662
Practice Address - Fax:203-852-3683
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT48469208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI23061Medicare UPIN
CAWA87112CMedicare ID - Type Unspecified