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General NPI Number Information
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NPI Number | 1164648093
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Entity Type | Individual
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Provider Name | JOANNE INTRATOR M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 610 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10021-7025
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Country | US
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Telephone | 212-737-6231
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Fax | 212-288-1885
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Provider Business Mailing Address
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Address Line | 23 REYNOLDS LN
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City | KATONAH
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State | NY
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Zip | 10536-3837
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Country | US
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Telephone | 914-234-0853
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Fax | 914-234-0201
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 151-263
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License Number State | NY
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