RUSSELL J FIRMAN MD
Physician/surgeon


Address: 112 Woodberry Lane, Fayetteville, NY 13066

RUSSELL J FIRMAN MD (Credential# 558424) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 1, 2018. The license expiration date date is October 31, 2019. The license status is INACTIVE.

Business Overview

RUSSELL J FIRMAN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040841. The credential type is physician/surgeon. The effective date is November 1, 2018. The expiration date is October 31, 2019. The business address is 112 Woodberry Lane, Fayetteville, NY 13066. The current status is inactive.

Basic Information

Licensee Name RUSSELL J FIRMAN MD
Credential ID 558424
Credential Number 1.040841
Credential Type Physician/Surgeon
Business Address 112 Woodberry Lane
Fayetteville
NY 13066
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2002-09-17
Effective Date 2018-11-01
Expiration Date 2019-10-31
Refresh Date 2020-02-03

Other licenses

ID Credential Code Credential Type Issue Term Status
316857 CSP.0032479 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2002-09-30 2017-03-01 - 2019-02-28 LAPSED

Office Location

Street Address 112 WOODBERRY LANE
City FAYETTEVILLE
State NY
Zip Code 13066

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James F Erba 106 Shady Lane, Fayetteville, NY 13066 Pharmacist 2018-02-01 ~ 2020-01-31
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Magdalena Pyo 317 Homewood Drive, Fayetteville, NY 13066 Registered Nurse 2020-02-01 ~ 2021-01-31
Joseph L. Charles 12 Landgrove Drive, Fayetteville, NY 13066 Certified Public Accountant License 2020-01-01 ~ 2020-12-31
Stephen G Tallman · Tag Mechanical Systems Inc 7013 Woodchuck Hill Rd, Fayetteville, NY 13066 Heating, Piping & Cooling Limited Contractor 2018-09-01 ~ 2019-08-31
Kelly A. Redmond 5155 Montgomery Road, Fayetteville, NY 13066 Certified Public Accountant Certificate ~
Haley Everding 808 South Manlius St., Fayetteville, NY 13066 Emergency Medical Technician ~
Alvin C White 1 Thistlewood Lane, Fayetteville, NY 13066 Registered Nurse 2015-07-01 ~ 2016-06-30
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Competitor

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City FAYETTEVILLE
Zip Code 13066
License Type Physician/Surgeon
License Type + County Physician/Surgeon + FAYETTEVILLE

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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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