MARIAM FARHAN (Credential# 2000016) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
MARIAM FARHAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.065591. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 76 Tyler Hill Rd, Naugatuck, CT 06770-3193. The current status is active.
| Licensee Name | MARIAM FARHAN |
| Credential ID | 2000016 |
| Credential Number | 1.065591 |
| Credential Type | Physician/Surgeon |
| Business Address |
76 Tyler Hill Rd Naugatuck CT 06770-3193 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2020-05-14 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-16 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1432546 | CSP.0065999 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-06-22 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 1487734 | 1.057416-RES | Resident Physician | 2017-07-01 | 2017-07-01 - 2020-06-30 | ACTIVE |
| 1592208 | CSP.0069310 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | - | INACTIVE |
| Street Address | 76 TYLER HILL RD |
| City | NAUGATUCK |
| State | CT |
| Zip Code | 06770-3193 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vanessa Cardenas | 68 Tyler Hill Rd, Naugatuck, CT 06770-3193 | Esthetician | 2020-06-26 ~ 2022-03-31 |
| Carol A Work | 60 Tyler Hill Rd, Naugatuck, CT 06770-3193 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Abigail E Hull-gulotta | 38 Tyler Hill Rd, Naugatuck, CT 06770-3193 | Physical Therapist | 2020-06-01 ~ 2021-05-31 |
| Seth Fardy | 49 Tyler Hill Rd, Naugatuck, CT 06770-3193 | Electrical Unlimited Journeyperson | 2019-10-31 ~ 2020-09-30 |
| Nicolita Manasoiu | 33 Tyler Hill Rd, Naugatuck, CT 06770-3193 | Massage Therapist | 2019-08-01 ~ 2021-07-31 |
| Luis A Rodriguez | 52 Tyler Hill Rd, Naugatuck, CT 06770-3193 | Emergency Medical Responder | 2019-07-01 ~ 2022-06-30 |
| Jerrica Rodriguez | 52 Tyler Hill Rd, Naugatuck, CT 06770-3193 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mardiny Khvay | 152 Cherry St, Naugatuck, CT 06770 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-09-30 |
| Jennifer D Arsan-siemasko | 26 Seth Dr, Naugatuck, CT 06770 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Margaret R Berge | 375 May St, Naugatuck, CT 06770 | Master's Level Social Worker - Temporary Permit | 2020-06-26 ~ 2020-09-14 |
| Ilene Zayas | 38 Arch St., Naugatuck, CT 06770 | Medication Administration Certification | ~ |
| Paula M Coelho | 56 Jolie Road, Naugatuck, CT 06770 | Dental Hygienist | 2020-07-01 ~ 2021-06-30 |
| Shannen Grace Welz | 292 Spencer St, Naugatuck, CT 06770 | Esthetician | ~ |
| Tanjala M Samuels | 15 Lorann Circle, Naugatuck, CT 06770 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Andrea Lee Evans | 216 Spring Street Unit 17, Naugatuck, CT 06770 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jay Haack | 589 High Street, Naugatuck, CT 06770 | Medication Administration Certification | 2018-07-12 ~ 2020-07-11 |
| Kathleen B Chiarella | 67 Melbourne St, Naugatuck, CT 06770 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06770 | |||
| City | NAUGATUCK |
| Zip Code | 06770 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NAUGATUCK |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Farhan A Matin | 464 74th Street, Brooklyn, NY 11209 | Physician/surgeon | 2009-07-08 ~ 2010-07-31 |
| Farhan Omar Karim | 315 N Steele Road, West Hartford, CT 06117 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Mariam Avetisova | 321 Hayden St Apt D, Sayre, PA 18840-1623 | Physician/surgeon | ~ |
| Ankur Gupta | 10835 Mariam Ln, Dayton, OH 45458 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Ghousia Mariam Alikhan | 100 Barron Circle, Somerset, NJ 08873 | Physician/surgeon | 2017-09-08 ~ 2018-02-28 |
| Mariam Sofia Aboian | 3 Marion Lane, Woodbridge, CT 06525 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Mariam Hasan | 15891 Los Gatos Almaden Rd, Los Gatos, CA 95032 | Physician/surgeon | ~ |
| Mariam Tsikvadze | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2018-06-28 ~ 2018-07-27 |
| Mariam Tsikvadze | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2018-06-28 ~ 2022-06-30 |
| Farhan N Masani | 530 Old Country Rd, Westbury, NY 11590 | Podiatrist | 1995-09-26 ~ 1996-09-30 |
Please comment or provide details below to improve the information on MARIAM FARHAN.
| 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).