TARA NICOLE CARLESCO (Credential# 1523877) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
TARA NICOLE CARLESCO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.004160. The credential type is physician assistant. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 2200 Whitney Avenue, Hamden, CT 06518. The current status is active.
| Licensee Name | TARA NICOLE CARLESCO |
| Credential ID | 1523877 |
| Credential Number | 23.004160 |
| Credential Type | Physician Assistant |
| Business Address |
2200 Whitney Avenue Hamden CT 06518 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-07-12 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-12-17 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1530373 | CSP.0069041 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-07-16 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 2200 Whitney Avenue |
| City | Hamden |
| State | CT |
| Zip Code | 06518 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Francis W Chan Md | 2200 Whitney Avenue, Hamden, CT 06518 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mark B Taylor Md | 2200 Whitney Avenue, Hamden, CT 06518 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Steve Angelo | 2200 Whitney Avenue, Hamden, CT 06518 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Renu Bazaz-kapoor | 2200 Whitney Avenue, Hamden, CT 06518 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Taneisha R Grant | 2200 Whitney Avenue, Hamden, CT 06518 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Paul Feuerstadt Md | 2200 Whitney Avenue, Hamden, CT 06518 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Renuka Umashanker Md | 2200 Whitney Avenue, Hamden, CT 06518 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Rebecca J Grillo Pa | 2200 Whitney Avenue, Hamden, CT 06518-3602 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Renu Boatright | 2200 Whitney Avenue, Hamden, CT 06518 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Randy Johnson Pa | 2200 Whitney Avenue, Hamden, CT 06518 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Barbara Esposito Aprn | 209 Todd St, Hamden, CT 06518 | Advanced Practice Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Sorrentos Brick Oven Pizzeria | 244 Skiff St, Hamden, CT 06518 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Jenna Bump | 61 Cannon St, Hamden, CT 06518 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jennifer E Pohl | 70 Norwood Avenue, Hamden, CT 06518 | Speech and Language Pathologist | 2020-07-01 ~ 2021-06-30 |
| Nicole O Miller-tyson | 648 Evergreen Ave, Hamden, CT 06518 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Nancy D Anderson | 399 Hillfield Road, Hamden, CT 06518 | Speech and Language Pathologist | 2020-08-01 ~ 2021-07-31 |
| Flowers From The Farm | 1035 Shepard Avenue, Hamden, CT 06518 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Lynda Burke | 68 Linden Avenue, Hamden, CT 06518 | Notary Public Appointment | 2011-12-08 ~ 2016-12-31 |
| Kelly Lynn Huppert | 1334 Town Walk Dr, Hamden, CT 06518 | Master's Level Social Worker | ~ |
| Robert L Engengro | 365 Forest Street, Hamden, CT 06518 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Find all Licenses in zip 06518 | |||
| City | Hamden |
| Zip Code | 06518 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Hamden |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Tara Michelle Laforge | 245 5th Ave, New York, NY 10016 | Physician Assistant | ~ |
| Tara Jean Dempsey | 26 Roseland Ave, Meriden, CT 06450-6913 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Tara H Auth | 46 Jennifer Dr, North Haven, CT 06473-2040 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Tara R Flanagan | 18 Eskew Ct, Pine Bush, NY 12566-6618 | Physician Assistant | 2017-03-01 ~ 2018-02-28 |
| Courtney Nicole Enos | 916 1/2 4th St Ne, Byron, MN 55920-1530 | Physician Assistant | ~ |
| Nicole R Ciccia | 71 Joy Rd Apt C, Milford, CT 06460-6052 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Ashley Nicole Hiep | 3 Sgt. Demeola Rd., Blauvelt, NY 10913 | Physician Assistant | ~ |
| Nicole D Greco Pa | 604 Tompkins Ave Apt B5, Mamaroneck, NY 10543-3729 | Physician Assistant | 2015-03-01 ~ 2016-02-29 |
| Jaime A Camacho | 6 Nicole Ln, Burlington, CT 06013-2123 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Nicole S Feagin | 30 Shelburne Rd, Stamford, CT 06902-3628 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
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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).