MEDICARE: ALEXANDRA KROUDIS

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1013639566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA KROUDIS

Provider Business Mailing Address
First Line	:	166 BRIDGEPORT AVE # 2L
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06460-3935
Country	:	US
Telephone Number	:	973-570-0758
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 DURHAM RD STE 19
Second Line	:
City	:	MADISON
State	:	CT
Zip	:	06443-2657
Country	:	US
Telephone Number	:	973-570-0758
Fax Number	:

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

Provider Enumeration Date	:	09/12/2022
Last Update Date	:	09/12/2022

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Directions to “ ALEXANDRA KROUDIS ” Practice Location

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