PATRICK BRODERICK (Credential# 1461968) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
PATRICK BRODERICK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.057284-DO. The credential type is physician/surgeon. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 67 Rocky Hill Rd, New Fairfield, CT 06812-2709. The current status is active.
| Licensee Name | PATRICK BRODERICK |
| Credential ID | 1461968 |
| Credential Number | 1.057284-DO |
| Credential Type | Physician/Surgeon |
| Credential SubCategory | DO |
| Business Address |
67 Rocky Hill Rd New Fairfield CT 06812-2709 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-01-11 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-05-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1401224 | CSP.0064713 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-06-06 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 1490601 | 1.058703-RES | Resident Physician | 2017-07-01 | 2017-07-01 - 2019-06-30 | INACTIVE |
| Street Address | 67 ROCKY HILL RD |
| City | NEW FAIRFIELD |
| State | CT |
| Zip Code | 06812-2709 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth Pepin | 16 Cloverleaf Drive, New Fairfield, CT 06812 | Notary Public Appointment | ~ |
| Antoinett L Crawford | 60 Beaver Bog, New Fairfield, CT 06812 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Goodie Shoppe LLC (the) | 1 Brush Hill Rd, New Fairfield, CT 06812 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Jeffrey R Logel · Fairwood Wine & Liquor | 17 Route 39 Shaw's Plaza, New Fairfield, CT 06812 | Package Store Liquor | 2020-08-11 ~ 2021-08-10 |
| Joseph G Dimyan | 1 Lloyd Avenue, New Fairfield, CT 06812 | Real Estate Salesperson | 2020-06-24 ~ 2021-05-31 |
| Melanie Porter | 2 High Trail Ci Rd, New Fairfield, CT 06812 | Behavior Analyst | 2020-07-01 ~ 2021-06-30 |
| Dara E O'toole | 15 Muller Street, New Fairfield, CT 06812 | Radiographer | 2020-08-01 ~ 2021-07-31 |
| Anita Michelle Thompson | 15 Bauer Road, New Fairfield, CT 06812 | Registered Nurse | ~ |
| Maureen Salerno · Schully | 4 Old Orchard Road, New Fairfield, CT 06812 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| John N Devito IIi IIi | 9 Cloverleaf Drive, New Fairfield, CT 06812 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Find all Licenses in zip 06812 | |||
| City | NEW FAIRFIELD |
| Zip Code | 06812 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NEW FAIRFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patrick Byrne Broderick | Dr Patrick Broderick, Danbury, CT 06810 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Patrick A Broderick | Stamford Hospital, Stamford, CT 06904 | Physician/surgeon | 2010-10-01 ~ 2011-09-30 |
| Elisabeth C Broderick Md | 950 Massachusetts Ave 1a, Cambridge, MA 02139 | Physician/surgeon | 2004-01-20 ~ 2005-02-28 |
| Jordan W Greenberg | 700 Broderick St, San Francisco, CA 94117 | Physician/surgeon | 1997-03-24 ~ 1998-05-31 |
| John Dennis Broderick | 7755 Center Ave, Huntington Beach, CA 92647 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Daniel Broderick · Dan Broderick Carpentry | 40 Parsonage Hill Rd, Northford, CT 06472-1490 | Emergency Medical Technician | 2018-04-18 ~ 2021-04-01 |
| Patrick J Prepetit | 67 Franklin Ave # 2, Harrison, NY 10528-3542 | Physician/surgeon | ~ |
| Patrick W O'daly | 760 Route 52, Beacon, NY 12508 | Physician/surgeon | 1995-08-23 ~ 1996-09-30 |
| George S Patrick Md | 215 Main St Fl 3, Northampton, MA 01060-3122 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Patrick J Cahill Do | 999 Summer St Ste 401, Stamford, CT 06905-5546 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
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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).