Provider Demographics
NPI:1164648093
Name:INTRATOR, JOANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:INTRATOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 REYNOLDS LN
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-3837
Mailing Address - Country:US
Mailing Address - Phone:914-234-0853
Mailing Address - Fax:914-234-0201
Practice Address - Street 1:610 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-7025
Practice Address - Country:US
Practice Address - Phone:212-737-6231
Practice Address - Fax:212-288-1885
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151-2632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry