MICHAEL E GOLTZMAN (Credential# 1488496) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2017. The license expiration date date is June 30, 2022. The license status is ACTIVE.
MICHAEL E GOLTZMAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.057891-RES. The credential type is resident physician. The effective date is July 1, 2017. The expiration date is June 30, 2022. The business address is 39 North Way, Chappaqua, NY 10514-2212. The current status is active.
| Licensee Name | MICHAEL E GOLTZMAN |
| Credential ID | 1488496 |
| Credential Number | 1.057891-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
39 North Way Chappaqua NY 10514-2212 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-07-01 |
| Effective Date | 2017-07-01 |
| Expiration Date | 2022-06-30 |
| Refresh Date | 2018-05-07 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1425253 | CSP.0065533 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-05-22 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 39 NORTH WAY |
| City | CHAPPAQUA |
| State | NY |
| Zip Code | 10514-2212 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| James David Shorser | 480 Bedford Road Suite 4202, Chappaqua, NY 10514 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Sheryl Manasse | 5 Walden Hill, Chappaqua, NY 10514 | Master's Level Social Worker | 2020-08-01 ~ 2021-07-31 |
| Ross A Cole Briskman | 26 Douglas Rd, Chappaqua, NY 10514 | Architect | 2020-08-01 ~ 2021-07-31 |
| Eric M Dorsch | 37 Aldridge Road, Chappaqua, NY 10514 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Lauren R Safran | 6 Chappaqua Mountain Road, Chappaqua, NY 10514 | Licensed Clinical Social Worker | 2020-06-01 ~ 2021-05-31 |
| Stacy Weinberg | 75 High Way, Chappaqua, NY 10514 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
| Rita H Stern | Raveis 75 N Greeley Ave, Chappaqua, NY 10514 | Real Estate Salesperson | 2017-06-01 ~ 2018-05-31 |
| Samuel Goldfarb | 2 Sunset Drive North, Chappaqua, NY 10514 | Notary Public Appointment | 2015-05-29 ~ 2020-05-31 |
| John Panzone | 42 Hardscrabble Hill Road 42 Hardscrabble Hill Roa, Chappaqua, NY 10514 | Physician/surgeon | ~ |
| Boris Usherenko | 480 Bedford Road, Chappaqua, NY 10514 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Find all Licenses in zip 10514 | |||
| City | CHAPPAQUA |
| Zip Code | 10514 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + CHAPPAQUA |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael Kuo | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-06-24 ~ 2021-06-30 |
| Michael Nowicki | 155 Joy Rd, Waterbury, CT 06708-2464 | Resident Physician | 2013-06-28 ~ 2019-06-27 |
| Michael E. Gotlib | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2013-07-01 ~ 2018-06-30 |
| Michael A Hajek | 256 Edwards St, New Haven, CT 06511 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Michael Rubin | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-08-01 ~ 2021-06-30 |
| Michael A Persaud | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Michael O'neill | 24 Hospital Ave, Danbury, CT 06810 | Resident Physician | 2017-06-22 ~ 2020-06-30 |
| Michael N Levitz | 71 Haynes St, Manchester, CT 06040-4131 | Resident Physician | 2017-07-01 ~ 2020-10-29 |
| Michael T. Geraghty | 64 Robbins St, Waterbury, CT 06708-2613 | Resident Physician | 2019-06-28 ~ 2024-06-27 |
| Michael Hanwei He | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-06-15 ~ 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).