POUYAN NICK CHANGIZZADEH (Credential# 1669701) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is June 19, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
POUYAN NICK CHANGIZZADEH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0071613. The credential type is controlled substance registration for practitioner. The effective date is June 19, 2019. The expiration date is February 28, 2021. The business address is 630 Smithfield Rd Apt 1112, North Providence, RI 02904-2932. The current status is active.
| Licensee Name | POUYAN NICK CHANGIZZADEH |
| Credential ID | 1669701 |
| Credential Number | CSP.0071613 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
630 Smithfield Rd Apt 1112 North Providence RI 02904-2932 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-06-19 |
| Effective Date | 2019-06-19 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-06-19 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1636031 | 1.063718 | Physician/Surgeon | 2019-06-18 | 2019-10-01 - 2020-09-30 | ACTIVE |
| Street Address | 630 SMITHFIELD RD APT 1112 |
| City | NORTH PROVIDENCE |
| State | RI |
| Zip Code | 02904-2932 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven Francis Massucci | 630 Smithfield Rd Apt 1003, North Providence, RI 02904-2932 | Podiatrist | 2020-06-16 ~ 2020-11-30 |
| Carmen Bissessar | 630 Smithfield Rd Apt 1019, North Providence, RI 02904-2932 | Registered Nurse | 2020-02-18 ~ 2020-07-31 |
| Kristie M Massucci | 630 Smithfield Rd Apt 1003, North Providence, RI 02904-2932 | Registered Nurse | 2020-03-04 ~ 2020-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric N Zuena | 2 Charles Street, Providence, RI 02904 | Architect | 2020-08-01 ~ 2021-07-31 |
| Michal Marcin Szpara | 630 Smithfield Rd Unit 316, North Providence, RI 02904 | Podiatrist | 2020-06-01 ~ 2021-05-31 |
| Peter E Cardin | 50 Thurber St., North Providence, RI 02904 | Casino Class I Employee | 2020-02-26 ~ 2020-10-31 |
| Stephen Mcgill | 45 Anderton Ave., North Providence, RI 02904 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Jabriel J Abdullah | 24 Vaughan Street, Providence, RI 02904 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Robert J De Mattio Jr. | 111a Turnessa Green, North Providence, RI 02904 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| R P Z Realty Inc | 1417 Douglas Ave, North Providence, RI 02904 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
| Elizabeth Marie Staley | 13 Ternay Gdns, Providence, RI 02904 | Registered Nurse | ~ |
| Tasha D Hendricks | 25 Benedict Street, North Providence, RI 02904 | Registered Nurse | ~ |
| Kenneth Conte | 9 Carriage Way, N Providence, RI 02904 | Land Surveyor | 2020-02-01 ~ 2021-01-31 |
| Find all Licenses in zip 02904 | |||
| City | NORTH PROVIDENCE |
| Zip Code | 02904 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NORTH PROVIDENCE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nick Ramandi | Po Box 52, Middletown, CT 06457-0052 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Nick H Gabriel Do | 65 Robin Court, Middletown, CT 06457 | Controlled Substance Registration for Practitioner | 2001-03-01 ~ 2002-02-28 |
| Nick Dorko Dvm | 439 Marlborough Road, Glastonbury, CT 06033 | Controlled Substance Registration for Practitioner | 2002-03-05 ~ 2003-02-28 |
| Nick M Mobilia | 31 Hilltop Dr, North Salem, NY 10560-2214 | Controlled Substance Registration for Practitioner | 2019-08-19 ~ 2021-02-28 |
| Nick Florio | 21 South Street, Ridgefield, CT 06877 | Controlled Substance Registration for Practitioner | 2019-02-25 ~ 2021-02-28 |
| Nick Mastromihalis | 101 South Bedford Rd., Mount Kisco, NY 10549 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Nick N Nicoloff | 100 Clear Wood Drive, Hastings On Hudson, NY 10706 | Controlled Substance Registration for Practitioner | 2015-06-29 ~ 2017-02-28 |
| Peter Nick Christ Fotinos | 8133 Ardrey Kell Rd Ste 201, Charlotte, NC 28277-5723 | Controlled Substance Registration for Practitioner | 2020-06-24 ~ 2021-02-28 |
| Nick Associated Inc | 88 Mayfair Ave, West Hempstead, NY 11552 | Home Improvement Contractor | 2000-12-01 ~ 2001-11-30 |
| Nick Naples Inc | 22 Village Place, Glastonbury, CT 06033 | Home Improvement Contractor | 1998-12-01 ~ 1999-11-30 |
Please comment or provide details below to improve the information on POUYAN NICK CHANGIZZADEH.
| 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).