SUSANNAH M BERNHEIM MD
Physician/surgeon


Address: 175 Linden St, New Haven, CT 06511-2407

SUSANNAH M BERNHEIM MD (Credential# 560672) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is February 6, 2020. The license expiration date date is August 31, 2020. The license status is ACTIVE.

Business Overview

SUSANNAH M BERNHEIM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.043090. The credential type is physician/surgeon. The effective date is February 6, 2020. The expiration date is August 31, 2020. The business address is 175 Linden St, New Haven, CT 06511-2407. The current status is active.

Basic Information

Licensee Name SUSANNAH M BERNHEIM MD
Credential ID 560672
Credential Number 1.043090
Credential Type Physician/Surgeon
Business Address 175 Linden St
New Haven
CT 06511-2407
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2005-02-04
Effective Date 2020-02-06
Expiration Date 2020-08-31
Refresh Date 2020-02-06

Other licenses

ID Credential Code Credential Type Issue Term Status
507725 CSP.0043763 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2008-07-08 2015-07-23 - 2017-02-28 INACTIVE

Office Location

Street Address 175 LINDEN ST
City NEW HAVEN
State CT
Zip Code 06511-2407

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Cary M Tucker 64 Bishop St, New Haven, CT 06511 Architect 2020-08-01 ~ 2021-07-31
Frank J Pannenborg 505 Ellsworth Ave, New Haven, CT 06511 Architect 2020-08-01 ~ 2021-07-31
Crystal E Gooding 26 Woodland Street, New Haven, CT 06511 Notary Public Appointment 2020-07-01 ~ 2025-06-30
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Competitor

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City NEW HAVEN
Zip Code 06511
License Type Physician/Surgeon
License Type + County Physician/Surgeon + NEW HAVEN

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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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