Provider Demographics
NPI:1790753184
Name:WOODLEY, ANTHEA FIONA (MD)
Entity Type:Individual
Prefix:
First Name:ANTHEA
Middle Name:FIONA
Last Name:WOODLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 STORRS RD
Mailing Address - Street 2:STE 6
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226
Mailing Address - Country:US
Mailing Address - Phone:860-423-9207
Mailing Address - Fax:860-423-9983
Practice Address - Street 1:6 STORRS RD
Practice Address - Street 2:STE 6
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226
Practice Address - Country:US
Practice Address - Phone:860-423-9207
Practice Address - Fax:860-423-9983
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030287207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
F14029Medicare UPIN