Healthcare Provider Details
I. General information
NPI: 1144890211
Provider Name (Legal Business Name): ALEXANDRA POPA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/30/2021
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2507 BROWNCROFT BLVD STE 106B
ROCHESTER NY
14625-1523
US
IV. Provider business mailing address
2507 BROWNCROFT BLVD STE 106B
ROCHESTER NY
14625-1523
US
V. Phone/Fax
- Phone: 585-310-4490
- Fax:
- Phone: 585-310-4490
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TS0200X |
| Taxonomy | School Psychologist |
| License Number | 026201 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 026201 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: