Provider Demographics
NPI:1154115061
Name:TROCCOLI, PETER SCIARRETTA (DPM)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:SCIARRETTA
Last Name:TROCCOLI
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22201 MOROSS RD PROFESSIONAL BUILDING 2 STE 250
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236-5009
Mailing Address - Country:US
Mailing Address - Phone:313-343-6393
Mailing Address - Fax:
Practice Address - Street 1:22201 MOROSS RD PROFESSIONAL BUILDING 2 STE 250
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2175
Practice Address - Country:US
Practice Address - Phone:313-343-6393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program