KIMBERLY A. BASILE (Credential# 1308058) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
KIMBERLY A. BASILE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0061399. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 5 Perryridge Road, Greenwich, CT 06830. The current status is lapsed.
| Licensee Name | KIMBERLY A. BASILE |
| Credential ID | 1308058 |
| Credential Number | CSP.0061399 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5 Perryridge Road Greenwich CT 06830 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2015-09-01 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1182942 | 23.003008 | Physician Assistant | 2013-10-10 | 2017-04-01 - 2018-03-31 | INACTIVE |
| Street Address | 5 Perryridge Road |
| City | Greenwich |
| State | CT |
| Zip Code | 06830 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Deepa Jansen | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Ginamarie Papia | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Ju Young Bae | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Michael Foti | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Waqas Salam | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Romelle J Maloney | 5 Perryridge Road, Greenwich, CT 06830 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kristin T Hsieh | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2020-06-22 ~ 2021-06-28 |
| Fatema S Esaa | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2020-06-22 ~ 2021-06-28 |
| Eunjin Park | 5 Perryridge Road, Greenwich, CT 06831 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Jeremy B Barowsky | 5 Perryridge Road, Greenwich, CT 06830 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Junior League of Greenwich Conn Inc. | 231 East Putnam Ave., Greenwich, CT 06830 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Michelle Yoo | 35 Putnam Green, Greenwich, CT 06830 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-01-31 |
| Michele S Bergen | Greenwich Medical Building, Greenwich, CT 06830 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Black Forest Pastry | 52 Lewis Street, Greenwich, CT 06830 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Maurasaca Pallchisaca Gloria Veronica | 103 Greenwich Ave, Greenwich, CT 06830 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Deborah B Huffard | 107 Maple Ave, Greenwich, CT 06830 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Joann H Alexander | 157 Stanwich Road, Greenwich, CT 06830 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Dandan Tu | 24 Byfield Ln, Greenwich, CT 06830 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Mohamed Akli Zetchi | 2 Perryridge Road, Greenwich, CT 06830 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Gateway Classical Music Society Inc | 292 Stanwich Road, Greenwich, CT 06830 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Find all Licenses in zip 06830 | |||
| City | Greenwich |
| Zip Code | 06830 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Greenwich |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John X R Basile Md | 6 Grosvenor Place, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 2000-05-05 ~ 2001-02-28 |
| Duncan Gill Md | 3 Basile Road, Granby, CT 06035 | Controlled Substance Registration for Practitioner | 2004-03-22 ~ 2005-02-28 |
| Basile Njei | Primary Care, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2013-03-17 ~ 2015-02-28 |
| Kimberly A Keegan | 4 Den Rd, New Hartford, CT 06057-3502 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly A George Pa | 88 Ridgefield Dr, Middletown, CT 06457-6540 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Kimberly Brown | 435 Lewis Ave, Meriden, CT 06451 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly H Leahy | 73 Lockwood St. Ext., Meriden, CT 06451 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly W Keefe | 20 York St Tmp 209, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Kimberly F Lauth | 108 Church St Apt 406, New Haven, CT 06510-3008 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Kimberly Zeller Md | 8 Cottage St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2003-01-24 ~ 2004-02-28 |
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| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).