Healthcare Provider Details

I. General information

NPI: 1992679765
Provider Name (Legal Business Name): MRS. ALEXIS JUNE GAETANO FOX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 N GOODMAN ST STE A300
ROCHESTER NY
14607-1171
US

IV. Provider business mailing address

274 N GOODMAN ST STE A300
ROCHESTER NY
14607-1171
US

V. Phone/Fax

Practice location:
  • Phone: 585-206-2631
  • Fax:
Mailing address:
  • Phone: 585-206-2631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number133198
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: