Provider Demographics
NPI:1003379918
Name:WINCHESTER, ANNA (DO)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:WINCHESTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 GLASTONBURY PL UNIT 303
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4446
Mailing Address - Country:US
Mailing Address - Phone:317-531-2893
Mailing Address - Fax:
Practice Address - Street 1:1665 ELLINGTON RD
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2778
Practice Address - Country:US
Practice Address - Phone:860-648-2447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT19121981208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics