MEDICARE: ALEXANDRIA ROSE XEPOLITOS FNP

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	363LF0000X	Family Nurse Practitioner	349290	NY

General Provider Information

NPI Number	:	1538808191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRIA ROSE XEPOLITOS FNP

Provider Business Mailing Address
First Line	:	67 DEWEY AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-2101
Country	:	US
Telephone Number	:	570-249-0564
Fax Number	:

Provider Business Practice Location Address
First Line	:	1975 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3515
Country	:	US
Telephone Number	:	646-558-2424
Fax Number	:

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

Provider Enumeration Date	:	06/01/2022
Last Update Date	:	06/23/2026

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