Individual
DR. MARY ELLEN GRACE FOTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
25 STANIFORD ST, CLINICAL AND PROFESSIONAL SERVICES, BOSTON, MA 02114-2503
(617) 626-8116
(617) 626-8225
Mailing address
320 POPLAR ST, ROSLINDALE, MA 02131-4339
(617) 327-7595
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
54163
MA
2084P0800X
Psychiatry Physician
54163
MA
2084P0800X
Psychiatry Physician
Primary
ME 60283
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J05992
BCBS
MA
Enumeration date
01/23/2007
Last updated
09/11/2025
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