MEDICARE: ALEXANDRA MARCOVICCI MD

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	2084P0800X	Psychiatry Physician	60723	KY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2084P0804X	Child & Adolescent Psychiatry Physician	35.152729	OH

General Provider Information

NPI Number	:	1215686688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA MARCOVICCI MD

Provider Business Mailing Address
First Line	:	1325 KNOWLTON ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45223-2124
Country	:	US
Telephone Number	:	917-306-2544
Fax Number	:

Provider Business Practice Location Address
First Line	:	1325 KNOWLTON ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45223-2124
Country	:	US
Telephone Number	:	917-306-2544
Fax Number	:

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

Provider Enumeration Date	:	03/22/2022
Last Update Date	:	01/27/2026

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