Provider Demographics
NPI:1134347123
Name:INTRILIGATOR, ROXANN (MS,MA)
Entity type:Individual
Prefix:MRS
First Name:ROXANN
Middle Name:
Last Name:INTRILIGATOR
Suffix:
Gender:F
Credentials:MS,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WESTMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-1008
Mailing Address - Country:US
Mailing Address - Phone:914-772-7592
Mailing Address - Fax:
Practice Address - Street 1:2269 SAW MILL RIVER RD
Practice Address - Street 2:BUILDING 1A
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3832
Practice Address - Country:US
Practice Address - Phone:914-345-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR11951700163WP0809X
NY308911-1163WP0809X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult