Healthcare Provider Details

I. General information

NPI: 1699353508
Provider Name (Legal Business Name): MICHAEL LEE WINCHESTER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 CORBIN AVE
NEW BRITAIN CT
06053-2298
US

IV. Provider business mailing address

2150 CORBIN AVE
NEW BRITAIN CT
06053-2298
US

V. Phone/Fax

Practice location:
  • Phone: 860-612-6305
  • Fax: 860-612-6304
Mailing address:
  • Phone: 860-612-6305
  • Fax: 860-612-6304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number82867
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: