SHANTI NULU
Physician/surgeon


Address: 107 W 123rd Street, New York, NY 10027

SHANTI NULU (Credential# 1300498) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 2, 2015. The license expiration date date is December 31, 2016. The license status is INACTIVE.

Business Overview

SHANTI NULU is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.054792. The credential type is physician/surgeon. The effective date is December 2, 2015. The expiration date is December 31, 2016. The business address is 107 W 123rd Street, New York, NY 10027. The current status is inactive.

Basic Information

Licensee Name SHANTI NULU
Credential ID 1300498
Credential Number 1.054792
Credential Type Physician/Surgeon
Business Address 107 W 123rd Street
New York
NY 10027
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2015-12-02
Effective Date 2015-12-02
Expiration Date 2016-12-31
Refresh Date 2017-04-05

Office Location

Street Address 107 W 123rd Street
City New York
State NY
Zip Code 10027

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Competitor

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City New York
Zip Code 10027
License Type Physician/Surgeon
License Type + County Physician/Surgeon + New York

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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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