SHARMINI M JAYAMAHA
Physician/surgeon


Address: 21 Cottonwood Avenue, Port Jefferson, NY 11776

SHARMINI M JAYAMAHA (Credential# 554431) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 14, 2000. The license expiration date date is May 31, 2001. The license status is INACTIVE.

Business Overview

SHARMINI M JAYAMAHA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.036840. The credential type is physician/surgeon. The effective date is April 14, 2000. The expiration date is May 31, 2001. The business address is 21 Cottonwood Avenue, Port Jefferson, NY 11776. The current status is inactive.

Basic Information

Licensee Name SHARMINI M JAYAMAHA
Credential ID 554431
Credential Number 1.036840
Credential Type Physician/Surgeon
Business Address 21 Cottonwood Avenue
Port Jefferson
NY 11776
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1998-05-08
Effective Date 2000-04-14
Expiration Date 2001-05-31
Refresh Date 2009-07-08

Office Location

Street Address 21 COTTONWOOD AVENUE
City PORT JEFFERSON
State NY
Zip Code 11776

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Licensee Name Office Address Credential Effective / Expiration
Joanne Louise Downing 7 Cully Street, Port Jefferson Station, NY 11776 Physical Therapist 2020-04-01 ~ 2021-03-31
Beth Anne Travis 307 Woodhull Ave, Port Jefferson Station, NY 11776 Registered Nurse - Temporary 2020-04-22 ~ 2020-08-20
Kelly Ann Kosciuk 5 Hancock Street, Port Jefferson Station, NY 11776 Registered Nurse 2020-03-06 ~ 2021-02-28
Praimchand Nardeo 15a East Grove Street, Port Jefferson Station, NY 11776 Tax Preparer/facilitator Permit 2020-02-11 ~ 2022-02-28
Paul Lappano 45 Bedford Ave, Port Jefferson Station, NY 11776 Professional Engineer 2020-02-01 ~ 2021-01-31
Stewart D Charaton 3 Exeter Drive, Port Jefferson Station, NY 11776 Notary Public Appointment 2005-12-28 ~ 2010-12-31
Jeffrey Lee Vacirca 1500 Route 112 Building 4, Port Jefferson Station, NY 11776 Physician/surgeon 2020-02-01 ~ 2021-01-31
Kristen Youngberg 1 Evelyn Rd, Port Jeff Sta, NY 11776 Massage Therapist 2018-09-19 ~ 2020-09-30
Paul Alan Werfel 36 Sahenandoah Avlvd, Port Jefferson Station, NY 11776 Emergency Medical Technician ~
Clark S Homan 2 Pagnotta Drive, Port Jefferson, NY 11776 Physician/surgeon 2007-09-24 ~ 2008-10-31
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City PORT JEFFERSON
Zip Code 11776
License Type Physician/Surgeon
License Type + County Physician/Surgeon + PORT JEFFERSON

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Dataset Information

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).

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