TZIVIA R MOREEN
Physician/surgeon


Address: 139 West Ln, Stamford, CT 06905-3956

TZIVIA R MOREEN (Credential# 1074088) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.

Business Overview

TZIVIA R MOREEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.051203. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 139 West Ln, Stamford, CT 06905-3956. The current status is active.

Basic Information

Licensee Name TZIVIA R MOREEN
Credential ID 1074088
Credential Number 1.051203
Credential Type Physician/Surgeon
Business Address 139 West Ln
Stamford
CT 06905-3956
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2012-07-17
Effective Date 2020-06-01
Expiration Date 2021-05-31
Refresh Date 2020-05-26

Other licenses

ID Credential Code Credential Type Issue Term Status
1121670 CSP.0053668 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2012-09-10 2019-03-01 - 2021-02-28 ACTIVE

Office Location

Street Address 139 WEST LN
City STAMFORD
State CT
Zip Code 06905-3956

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Competitor

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City STAMFORD
Zip Code 06905
License Type Physician/Surgeon
License Type + County Physician/Surgeon + STAMFORD

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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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