ADAM SPIVACK (Credential# 556382) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
ADAM SPIVACK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.038794. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 4479 Kingscote Road, BC VOR 1N2. The current status is active.
| Licensee Name | ADAM SPIVACK |
| Credential ID | 556382 |
| Credential Number | 1.038794 |
| Credential Type | Physician/Surgeon |
| Business Address |
4479 Kingscote Road BC VOR 1N2 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2000-06-23 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-02-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 244128 | CSP.0030185 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2000-10-11 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 4479 KINGSCOTE ROAD |
| State | BC |
| Zip Code | VOR 1N2 |
| Zip Code | VOR 1 |
| License Type | Physician/Surgeon |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Julie Spivack Md | 425 Post Rd, Fairfield, CT 06824 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Barney Spivack Md | 101 Long Lots Road, Westport, CT 06880 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
| George Spivack Md · Internal Medicine Associates, P.C. | Consulting Cardiologists, PC, Wallingford, CT 06492-6012 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Adam Critchfield | 454 Manhattan Ave, New York, NY 10026-1088 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Adam Lande | 23 Churchill Rd, Cresskill, NJ 07626 | Physician/surgeon | 1995-06-08 ~ 1996-03-31 |
| Adam Steinlauf Md | 100 Morgan St, Stamford, CT 06905 | Physician/surgeon | 1999-12-13 ~ 2001-01-31 |
| Adam J Carter | 12 Tallwood Rd, Woodbridge, CT 06525-1932 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Adam L Ackerman | 22 Cassway Rd, Woodbridge, CT 06525-1215 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Adam K Berkwitt Md | 333 Cedar St, New Haven, CT 06520-8064 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Adam Cheifetz Md | 615 Reef Rd, Fairfield, CT 06824 | Physician/surgeon | 2004-01-20 ~ 2005-02-28 |
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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).