MICHAEL A MATILSKY
Physician/surgeon


Address: 650 Hallock Ave, Port Jefferson Station, NY 11776-1256

MICHAEL A MATILSKY (Credential# 1216690) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2017. The license expiration date date is March 31, 2018. The license status is PENDING.

Business Overview

MICHAEL A MATILSKY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.053149. The credential type is physician/surgeon. The effective date is April 1, 2017. The expiration date is March 31, 2018. The business address is 650 Hallock Ave, Port Jefferson Station, NY 11776-1256. The current status is pending.

Basic Information

Licensee Name MICHAEL A MATILSKY
Credential ID 1216690
Credential Number 1.053149
Credential Type Physician/Surgeon
Business Address 650 Hallock Ave
Port Jefferson Station
NY 11776-1256
Business Type INDIVIDUAL
Status PENDING - REINSTATEMENT APPLICATION PENDING
Issue Date 2014-06-13
Effective Date 2017-04-01
Expiration Date 2018-03-31
Refresh Date 2018-10-24

Office Location

Street Address 650 HALLOCK AVE
City PORT JEFFERSON STATION
State NY
Zip Code 11776-1256

Licenses in the same zip code

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
Find all Licenses in zip 11776

Competitor

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City PORT JEFFERSON STATION
Zip Code 11776
License Type Physician/Surgeon
License Type + County Physician/Surgeon + PORT JEFFERSON STATION

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Michael D Gribetz Po Box 650, New Hartford, NY 13413-0650 Physician/surgeon 2019-11-01 ~ 2020-10-31
Michael E Ripps 344 Third Ave, New York, NY 10010 Physician/surgeon 2011-08-01 ~ 2012-07-31
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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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