| Doctor Name: | TERESA Y INTORCIA |
| NPI Number: | 1023200508 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MNT |
| License Number: | 002834 |
| Business Practice Address: | 1001 West St Carthage, NY - 136199703 |
| Business Phone Number: | 3154931005 |
| Business Fax Number: | 3154930038 |
| Mailing Address: | 1001 West St, CARTHAGE |
| State: | NY |
| Postal Code: | 136199703 |
| Phone Number: | 3154931005 |
| Fax Number: | 3154930038 |
| NPI Enumeration Date: | 08/17/2007 |
| NPI Last Update Date: | 10/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | 002834 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |