Healthcare Provider Details

I. General information

NPI: 1467814970
Provider Name (Legal Business Name): CORINNE M. WEEKS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVENUE
FARMINGTON CT
06030-8085
US

IV. Provider business mailing address

263 FARMINGTON AVENUE
FARMINGTON CT
06030-8085
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-3387
  • Fax: 860-679-1494
Mailing address:
  • Phone: 860-679-3387
  • Fax: 860-679-1494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number073504
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: