Healthcare Provider Details

I. General information

NPI: 1275707275
Provider Name (Legal Business Name): JUDY KORIK WEINSTOCK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 WASHINGTON ST
WELLESLEY MA
02481-6202
US

IV. Provider business mailing address

75 SYLVAN ST STE B102
DANVERS MA
01923-2764
US

V. Phone/Fax

Practice location:
  • Phone: 781-235-5200
  • Fax: 781-235-1103
Mailing address:
  • Phone: 888-283-1722
  • Fax: 781-235-1103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number246068
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number246068
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: