Provider Demographics
NPI:1154324184
Name:WILLIAMS-WEEKES, TERRI ANTRENASE (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRI
Middle Name:ANTRENASE
Last Name:WILLIAMS-WEEKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:ANTRENASE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:711 TROY SCHENECTADY RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2442
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:47 NEW SCOTLAND AVE
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-3277
Practice Address - Fax:518-262-4210
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2032232085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04268888Medicaid
NY04268888Medicaid
FL80226Medicare ID - Type Unspecified