MATTHEW MICHAEL BORKOVICH (Credential# 1489226) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2018. The license expiration date date is June 30, 2021. The license status is ACTIVE.
MATTHEW MICHAEL BORKOVICH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.058472-RES. The credential type is resident physician. The effective date is July 1, 2018. The expiration date is June 30, 2021. The business address is 267 Grant St., Podium 4 Medical Education, Bridgeport, CT 06610-0120. The current status is active.
| Licensee Name | MATTHEW MICHAEL BORKOVICH |
| Credential ID | 1489226 |
| Credential Number | 1.058472-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
267 Grant St., Podium 4 Medical Education Bridgeport CT 06610-0120 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-06-25 |
| Effective Date | 2018-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-02-10 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1435064 | CSP.0066118 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-07-06 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 267 GRANT ST., PODIUM 4 MEDICAL EDUCATION |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06610-0120 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Safal Shetty | 267 Grant St., Podium 4 Medical Education, Bridgeport, CT 06610-0120 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ashwin Deshmukh | Bridgeport Hospital, Bridgeport, CT 06610-0120 | Controlled Substance Registration for Practitioner | 2019-06-28 ~ 2021-02-28 |
| Jay Parekh | 267 Grant Street, Bridgeport, CT 06610-0120 | Controlled Substance Registration for Practitioner | 2019-07-08 ~ 2021-02-28 |
| Jun Yi Lai | 267 Grant Street, Bridgeport, CT 06610-0120 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Bridgeport Hospital Foundation Inc. | Po Box 5000, Bridgeport, CT 06610-0120 | Public Charity-exempt From Financial Requirements | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nilca Janice Cardenales | 66 Rose St, Bridgeport, CT 06610 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Kiara Lizbeth Corporan | 10 Sturtevant Pl, Bridgeport, CT 06610 | Eyelash Technician | ~ |
| Alisha Garcia | 65 Berkeley Place, Bridgeport, CT 06610 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Pauline Parkes | 96 Virginia Avenue, Bridgeport, CT 06610 | Licensed Clinical Social Worker | ~ |
| Denise Reyes | 1125 Huntington Turnpike, Bridgeport, CT 06610 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Avery M Rilley | 80 Granfield Avenue, Bridgeport, CT 06610 | Pharmacy Technician | 2020-06-25 ~ 2021-03-31 |
| Bozena K. Malyszko | Bridgeport Hospital, Bridgeport, CT 06610 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Amy Espinosa | 146 Court D, Bridgeport, CT 06610 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Wilhelmina Jackson · Thomas | 172 Court D, Bridgeport, CT 06610 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Emma Agyeiwaa Vaczek | P.o Box 5223, Bridgeport, CT 06610 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06610 | |||
| City | BRIDGEPORT |
| Zip Code | 06610 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + BRIDGEPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Matthew Sabatino | 20 York St, New Haven, CT 06510 | Resident Physician | 2019-08-07 ~ 2021-06-30 |
| Matthew Factor | 929 Dublin St, New Orleans, LA 70118-1125 | Resident Physician | 2016-08-01 ~ 2021-06-30 |
| Matthew T Groenwald | 5 Perryridge Rd, Greenwich, CT 06830-4608 | Resident Physician | 2018-07-01 ~ 2019-06-30 |
| Matthew R. Austin | 20 York St, New Haven, CT 06510 | Resident Physician | 2018-07-01 ~ 2019-06-30 |
| Matthew Ringer | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Matthew P O'brien | 20 York St, New Haven, CT 06510 | Resident Physician | 2020-06-15 ~ 2021-06-30 |
| Matthew Klein | 675 Townsend Ave Unit 140, New Haven, CT 06512-3178 | Resident Physician | 2016-06-30 ~ 2020-06-30 |
| Jared Matthew Miller | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Matthew Reber Austin | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
| Matthew Deng | 7136 Ducketts Ln Apt 303, Elkridge, MD 21075-6899 | Resident Physician | 2015-06-25 ~ 2018-06-30 |
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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).