PHILIP A GOLDBERG MD (Credential# 215229) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
PHILIP A GOLDBERG MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0028370. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 688 East Main Street, Branford, CT 06405. The current status is active.
Licensee Name | PHILIP A GOLDBERG MD |
Credential ID | 215229 |
Credential Number | CSP.0028370 |
Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
Business Address |
688 East Main Street Branford CT 06405 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 1999-06-10 |
Effective Date | 2019-03-01 |
Expiration Date | 2021-02-28 |
Refresh Date | 2018-12-28 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
555338 | 1.037748 | Physician/Surgeon | 1999-05-21 | 2020-02-01 - 2021-01-31 | ACTIVE |
Street Address | 688 EAST MAIN STREET |
City | BRANFORD |
State | CT |
Zip Code | 06405 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
East Shore District Health Department | 688 East Main Street, Branford, CT 06405 | Outpatient Clinic | 2017-10-27 ~ 2021-09-30 |
Kayla Ennis Cunningham | 688 East Main Street, Branford, CT 06405-2988 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Raymond M Johnson | 39 Bayberry Lane, Branford, CT 06405 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Kirsten M Ranciato | 288 East Main Street, Branford, CT 06405 | Licensed Clinical Social Worker | 2020-08-01 ~ 2021-07-31 |
Bimala Khadka Thapa | 726 Robert Frost Dr., Branford, CT 06405 | Nail Technician | ~ |
Paul E Basile | 42 Valley Brook Road South, Branford, CT 06405 | Perfusionist | 2020-08-01 ~ 2021-07-31 |
Lupe Monica Placencia-muy | 100 East Main Street 2nd Fl, Branford, CT 06405 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-02-28 |
Bridget J Jennings | 159 Queach Road, Branford, CT 06405 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Ujeli Acharya | 21 Burban Drive, Branford, CT 06405 | Nail Technician | ~ |
Cathleen Smith | 50 First Avenue, Branford, CT 06405 | Radiographer | 2020-07-01 ~ 2021-06-30 |
Gita Thapa | 94 Village Lane, Branford, CT 06405 | Nail Technician | ~ |
Cycle Venture Partners Fund I Lp - Lumeda Series 1 | 50 Limewood Avenue, Branford, CT 06405 | Securities - Exemptions | 2020-06-17 ~ |
Find all Licenses in zip 06405 |
City | BRANFORD |
Zip Code | 06405 |
License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRANFORD |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Robert P Goldberg Md | 22 W Main St, Niantic, CT 06357-2340 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Shraga Goldberg Md | 140-21 69th Ave, Flushing, NY 11367 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
Jeffrey M O'connor Pa-c | 96 Goldberg Rd, Colchester, CT 06415 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Robin B Goldberg | 73 Avon St, New Haven, CT 06511-2422 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Frank E Goldberg | 256 N Main St, Manchester, CT 06042-2004 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Stephen A Goldberg Md | 3 Wakefield Rd, Scarsdale, NY 10583-7125 | Controlled Substance Registration for Practitioner | 2009-03-10 ~ 2011-02-28 |
Daniel E Goldberg | 69 Sand Pit Rd, Danbury, CT 06810 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2004-02-28 |
Jason Goldberg | 200 College St Apt 437, New Haven, CT 06510-2450 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Paul Goldberg | 20 Dawn Dr, Westport, CT 06880-2848 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Judith Goldberg-berman | 159 W Putnam Ave, Greenwich, CT 06830-5329 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).