MEDICARE: ALEXANDRA MARIA FOTIOU 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	194555	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	J400052189	OTHER	NY	MEDICARE GROUP J100044293

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801804505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA MARIA FOTIOU MD

Provider Business Mailing Address
First Line	:	89 GENESEE ST
Second Line	:	UNIT 4100
City	:	ROCHESTER
State	:	NY
Zip	:	14611-3201
Country	:	US
Telephone Number	:	585-368-3919
Fax Number	:	585-368-3918

Provider Business Practice Location Address
First Line	:	100 PINEWILD DR STE 2A
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14606-4200
Country	:	US
Telephone Number	:	585-368-6700
Fax Number	:	585-368-6767

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/03/2023

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