EDWIN DOMINGUEZ
Physician/surgeon


Address: 1729 Haight Ave, Bronx, NY 10461-1401

EDWIN DOMINGUEZ (Credential# 1222825) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 2, 2019. The license expiration date date is December 31, 2020. The license status is ACTIVE.

Business Overview

EDWIN DOMINGUEZ is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.053400. The credential type is physician/surgeon. The effective date is December 2, 2019. The expiration date is December 31, 2020. The business address is 1729 Haight Ave, Bronx, NY 10461-1401. The current status is active.

Basic Information

Licensee Name EDWIN DOMINGUEZ
Credential ID 1222825
Credential Number 1.053400
Credential Type Physician/Surgeon
Business Address 1729 Haight Ave
Bronx
NY 10461-1401
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2014-08-02
Effective Date 2019-12-02
Expiration Date 2020-12-31
Refresh Date 2019-12-02

Other licenses

ID Credential Code Credential Type Issue Term Status
1250588 CSP.0058899 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2014-10-29 2017-03-01 - 2019-02-28 LAPSED

Office Location

Street Address 1729 HAIGHT AVE
City BRONX
State NY
Zip Code 10461-1401

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Competitor

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City BRONX
Zip Code 10461
License Type Physician/Surgeon
License Type + County Physician/Surgeon + BRONX

Similar businesses

Licensee Name Office Address Credential Effective / Expiration
Heidi L Dominguez Kolek 95 Apple Ridge, West Springfield, MA 01089 Physician/surgeon 1999-03-08 ~ 2000-02-29
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Edwin A Spath Jr 859 Prospect Ave, W Hartford, CT 06105-4229 Physician/surgeon 2013-06-01 ~ 2014-05-31
Edwin D Lacuanan 3 Demartino Ave, Yonkers, NY 10703 Physician/surgeon 1996-08-05 ~ 1997-07-31
Edwin W Lojeski Do 310 Dakota Rd, Hailey, ID 83333 Physician/surgeon 2020-01-01 ~ 2020-12-31
Edwin D Williamson Md 88 Cottage St Apt 1, New Haven, CT 06511-2404 Physician/surgeon 2010-04-01 ~ 2011-03-31
Edwin V Tan 720 West 170th St, New York, NY 10032 Physician/surgeon 1996-02-26 ~ 1997-02-28
Edwin Tower Layng 307 S Evergreen Ave, Woodbury, NJ 08096-2739 Physician/surgeon 2020-06-01 ~ 2021-05-31
Edwin H Dombrowski Md Po Box 4201, Surf City, NC 28445 Physician/surgeon 1997-03-12 ~ 1998-04-30

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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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