JUDITH M MASCOLO MD (Credential# 460492) 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.
JUDITH M MASCOLO MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0041036. 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 639 Park Rd Ste 100, West Hartford, CT 06107-3443. The current status is active.
| Licensee Name | JUDITH M MASCOLO MD |
| Credential ID | 460492 |
| Credential Number | CSP.0041036 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
639 Park Rd Ste 100 West Hartford CT 06107-3443 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2007-01-17 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 554183 | 1.036592 | Physician/Surgeon | 1998-01-16 | 2019-10-01 - 2020-09-30 | ACTIVE |
| 195527 | CSP.0026743 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-03-01 - 2006-02-28 | INACTIVE |
| Street Address | 639 PARK RD STE 100 |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06107-3443 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patrick F Albergo | 639 Park Rd Ste 100, West Hartford, CT 06107-3443 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Duane F Austin | 639 Park Rd Ste 100, West Hartford, CT 06107-3443 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Desmond Ebanks Md | 639 Park Rd Fl 2, West Hartford, CT 06107-3443 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rebecca L Stansfield | 73 Tunxis Road, West Hartford, CT 06107 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Kumari Joshi | 44 Bentwood Rd, West Hartford, CT 06107 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Laurie C Caines Md | 205 Stoner Drive, West Hartford, CT 06107 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Nicole K. Edlund | 11 Greenacres Avenue, West Hartford, CT 06107 | Master's Level Social Worker - Temporary Permit | ~ |
| Andrea M Yuliano | 39 Mountain Terrace Road, West Hartford, CT 06107 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Elizabeth M Ineson | 4 Linwold Dr, West Htfd, CT 06107 | Architect | 2020-08-01 ~ 2021-07-31 |
| Sarah G Potter | 19 Westland Ave, West Hartford, CT 06107 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Jessica C Abreu | 14 Deepwood Lane, West Hartford, CT 06107 | Real Estate Salesperson | 2020-06-18 ~ 2021-05-31 |
| William C Richter | 67 Hillsboro Drive, West Hartford, CT 06107 | Architect | 2020-08-01 ~ 2021-07-31 |
| Teresa M Stanton | 25 Common Dr., West Hartford, CT 06107 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06107 | |||
| City | WEST HARTFORD |
| Zip Code | 06107 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WEST HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Joseph R Mascolo | 115 West Rd Apt 3821, Ellington, CT 06029-5714 | Controlled Substance Registration for Practitioner | 2019-06-25 ~ 2021-02-28 |
| Joseph Horvath | 255 Judith Dr, Stormville, NY 12582-5263 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Margot B Hampson | 15 Judith Dr, Danbury, CT 06811 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Judith R Marcus Md | 233 Mckinley Ave, New Haven, CT 06515-2009 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Judith A Faulkner | 1 New Haven Ave Ste 101, Milford, CT 06460-3398 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Judith G Pardo Md | Litchfield Ob/gyn PC, Torrington, CT 06790 | Controlled Substance Registration for Practitioner | 2004-02-29 ~ 2005-02-28 |
| Ritika Bansal | 197 Judith Ln Apt 1, Waterbury, CT 06704-1944 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Rakesh Hegde | 187 Judith Ln, Waterbury, CT 06704-1936 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Payal Trivedi Emery | 84 Judith Dr, Milford, CT 06461-2007 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Judith A Long Md | 414 South 24th St, Philadelphia, PA 1914 | Controlled Substance Registration for Practitioner | 1999-07-29 ~ 2000-02-28 |
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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).