JASON JEFFREY BRUCKER
Physician/surgeon


Address: 116 W 23rd St, New York, NY 10011

JASON JEFFREY BRUCKER (Credential# 1508183) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.

Business Overview

JASON JEFFREY BRUCKER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.061809. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 116 W 23rd St, New York, NY 10011. The current status is active.

Basic Information

Licensee Name JASON JEFFREY BRUCKER
Credential ID 1508183
Credential Number 1.061809
Credential Type Physician/Surgeon
Business Address 116 W 23rd St
New York
NY 10011
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2018-08-17
Effective Date 2020-05-01
Expiration Date 2021-04-30
Refresh Date 2020-02-26

Other licenses

ID Credential Code Credential Type Issue Term Status
1593938 CSP.0069351 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2018-08-20 2018-08-20 - 2019-02-28 LAPSED

Office Location

Street Address 116 W 23rd St
City NEW YORK
State NY
Zip Code 10011

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Competitor

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City NEW YORK
Zip Code 10011
License Type Physician/Surgeon
License Type + County Physician/Surgeon + NEW YORK

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Dataset Information

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).

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