MIRA HERMAN (Credential# 1348269) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
MIRA HERMAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.055515. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 2678 South Rd Ste 202, Poughkeepsie, NY 12601-5254. The current status is active.
| Licensee Name | MIRA HERMAN |
| Credential ID | 1348269 |
| Credential Number | 1.055515 |
| Credential Type | Physician/Surgeon |
| Business Address |
2678 South Rd Ste 202 Poughkeepsie NY 12601-5254 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-07-21 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-02-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1355770 | CSP.0062823 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-07-21 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 2678 SOUTH RD STE 202 |
| City | POUGHKEEPSIE |
| State | NY |
| Zip Code | 12601-5254 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Bruce R Gendron Md | 2678 South Rd Ste 202, Poughkeepsie, NY 12601-5254 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Nancy A Cooper | 2678 South Rd Ste 202, Poughkeepsie, NY 12601-5254 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Emil Shih Md | 2678 South Rd Ste 202, Poughkeepsie, NY 12601-5254 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Yiping Zhang | 2678 South Rd Ste 202, Poughkeepsie, NY 12601-5254 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Richard J Friedland Md | 2678 South Rd Ste 202, Poughkeepsie, NY 12601-5254 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jon M Lewis Md | 2678 South Rd Ste 202, Poughkeepsie, NY 12601-5254 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Michael Bromley Md | 2678 South Rd Ste 202, Poughkeepsie, NY 12601-5254 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Victor D Gaines Md | 2678 South Rd Ste 202, Poughkeepsie, NY 12601-5254 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Jonathan J Crystal Md | 2678 South Rd Ste 202, Poughkeepsie, NY 12601-5254 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Benjamin D Seckler Md · Imagining PC | 2678 South Rd Ste 202, Poughkeepsie, NY 12601-5254 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Dudley A Watson | 246 Mansion St., Poughkeepsie, NY 12601 | Asbestos Abatement Supervisor | 2020-06-01 ~ 2021-05-31 |
| Craig M Shannon | 47 Kingwood Dr, Poughkeepsie, NY 12601 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Maxwell Risch | 6 Marwood Dr, Poughkeepsie, NY 12601 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Chazen Engineering, Land Surveying & Landscape Architecture Ct LLC | 21 Fox St, Poughkeepsie, NY 12601 | Joint Practice | 2020-05-01 ~ 2021-04-30 |
| Paul Wright | 21 Reade Pl, Poughkeepsie, NY 12601 | Controlled Substance Registration for Practitioner | 2020-02-20 ~ 2021-02-28 |
| Faiz Y Bhora | 45 Reade Place, Dyson Cancer Center, 3rd Floor, Poughkeepsie, NY 12601 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| David M Quinn | 45 Reade Pl, Poughkeepsie, NY 12601 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Kelly Lynn Philiba | 12 Hanscom Ave, Poughkeepsie, NY 12601 | Naturopathic Physician | 2020-02-01 ~ 2021-01-31 |
| Danielle Williams | 2678 South Road, Suite 202, Poughkeepsie, NY 12601 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Laura M Baird | 350 Violet Ave, Poughkeepsie, NY 12601 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Find all Licenses in zip 12601 | |||
| City | POUGHKEEPSIE |
| Zip Code | 12601 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + POUGHKEEPSIE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mira K Makhijani | 135 Holmes Avenue, Darien, CT 06820 | Physician/surgeon | ~ 1998-04-30 |
| Herman Treitel | 8 Cedar Rd, Pt Jeff, NY 11777 | Physician/surgeon | 2005-12-29 ~ 2007-01-31 |
| Sean K Herman | 29 Scofield Ave, Apt 3, Stamford, CT 06906 | Physician/surgeon | 2005-03-09 ~ 2006-04-30 |
| Scott H Herman | 26 Lakeview Dr, Easton, CT 06612-1700 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Herman O Klein | 4 Schwartz St, Israel, 43213 | Physician/surgeon | 2010-02-01 ~ 2011-01-31 |
| Herman J Scharfenberger | 155 Turtle Bay Drive, Branford, CT 06405 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Charles K Herman | 1050 Fifth Avenue, New York, NY 10028 | Physician/surgeon | 2015-04-01 ~ 2016-03-31 |
| Sadee T Forde-cuffie | 11 Herman Ave, Darien, CT 06820-4304 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Steven D Herman | 160 East Linden Ave, Englewood, NJ 07631 | Physician/surgeon | 1996-04-08 ~ 1997-04-30 |
| Lora M Herman | 710 Forest Glade Dr., Chesapeake, VA 23322 | Physician/surgeon | 2009-03-18 ~ 2010-05-31 |
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| 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).