Healthcare Provider Details

I. General information

NPI: 1154324184
Provider Name (Legal Business Name): TERRI ANTRENASE WILLIAMS-WEEKES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRI ANTRENASE WILLIAMS M.D.

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE FL 3
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

711 TROY SCHENECTADY RD STE 203
LATHAM NY
12110-2461
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1537
  • Fax:
Mailing address:
  • Phone: 518-782-3700
  • Fax: 518-782-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG209307
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberG209307
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number203223
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: