JENNIFER KAYLIN PUCILOSKI (Credential# 1471086) is licensed (Physician Assistant) 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.
JENNIFER KAYLIN PUCILOSKI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.004059. The credential type is physician assistant. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 125 Mineola Ave, Roslyn Heights, NY 11577-2023. The current status is active.
| Licensee Name | JENNIFER KAYLIN PUCILOSKI |
| Credential ID | 1471086 |
| Credential Number | 23.004059 |
| Credential Type | Physician Assistant |
| Business Address |
125 Mineola Ave Roslyn Heights NY 11577-2023 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-03-08 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-01-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1533155 | CSP.0069187 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-07-27 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 125 MINEOLA AVE |
| City | ROSLYN HEIGHTS |
| State | NY |
| Zip Code | 11577-2023 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Spencer Holover | 125 Mineola Ave, Roslyn Heights, NY 11577-2023 | Controlled Substance Registration for Practitioner | 2020-03-12 ~ 2021-02-28 |
| Krostich & Krostich, Cpa's | 125 Mineola Ave, Roslyn Heights, NY 11577 | Certified Public Accountant Firm Permit | 2000-01-01 ~ 2000-12-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven L Malawer | 14 Browers Lane, Roslyn Heights, NY 11577 | Audiologist | 2020-06-01 ~ 2021-05-31 |
| Karen A Rummel Do | 16 Schoolhouse Lane, Roslyn Heights, NY 11577 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Oosman Tariq | 5 West Wood Circle, East Hills, NY 11577 | Physician/surgeon | 2020-02-25 ~ 2020-12-31 |
| James Greebel | 16 Thelma Street, Roslyn Heights, NY 11577 | Tax Preparer/facilitator Permit | 2020-02-11 ~ 2022-02-28 |
| Jeffrey Han | 122 Schoolhouse Ln, Roslyn Heights, NY 11577 | Professional Engineer | 2019-02-01 ~ 2020-01-31 |
| Hai-trieu Joseph L Pham | 48 Parkway Drive, Roslyn Heights, NY 11577 | Emergency Medical Technician | ~ |
| Alexander Arnowitz | 16 Laurel Lane, Roslyn Heights, NY 11577 | Notary Public Appointment | 2017-03-22 ~ 2022-03-31 |
| Ann Chu | 137 The Crescent, Roslyn Heights, NY 11577 | Notary Public Appointment | 2012-09-01 ~ 2017-08-31 |
| Surendra K Bhalla | 53 Pine Tree Lane, Roslyn Heights, NY 11577 | Professional Engineer | 1997-08-19 ~ 1998-01-31 |
| Kenneth F Standig | 264 Hillturn Lane, Roslyn Heights, NY 11577 | Professional Engineer | 2016-02-01 ~ 2017-01-31 |
| Find all Licenses in zip 11577 | |||
| City | ROSLYN HEIGHTS |
| Zip Code | 11577 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + ROSLYN HEIGHTS |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jennifer Wolfman | 47-33 245th St, Douglaston, NY 11362 | Physician Assistant | ~ |
| Jennifer Kowalczuk | 235 S Orchard St, Wallingford, CT 06492-4521 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Jennifer A Brook | 70 Litchfield Rd, Unionville, CT 06085-1318 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Jennifer Giacobbe | 583 Davenport Ave, New Rochelle, NY 10805-2119 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Jennifer R Lachance Pa | 7 Palmer Dr, Meriden, CT 06450-7078 | Physician Assistant | 2020-01-01 ~ 2020-12-31 |
| Jennifer H Hardy Pa | 86 Rimmon Rd, Woodbridge, CT 06525 | Physician Assistant | 2002-09-09 ~ 2003-09-30 |
| Jennifer L Irving | 28 Magnolia St., Norwalk, CT 06850 | Physician Assistant | 2009-01-13 ~ 2010-01-31 |
| Jennifer Kokalari Pa | 71 Applewood Rd, Branford, CT 06405-6104 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Jennifer A Clauss | 20 York St, New Haven, CT 06510 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Jennifer M Schloth | 336 E 18th St Apt 1a, New York, NY 10003-0610 | Physician Assistant | 2017-08-23 ~ 2018-08-31 |
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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).