DI SHI (Credential# 1503270) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
DI SHI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.060915. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 6 Horizon Rd, Fort Lee, NJ 07024-6652. The current status is active.
| Licensee Name | DI SHI |
| Credential ID | 1503270 |
| Credential Number | 1.060915 |
| Credential Type | Physician/Surgeon |
| Business Address |
6 Horizon Rd Fort Lee NJ 07024-6652 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-05-21 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1283469 | CSP.0060170 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2015-05-13 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 1518313 | CSP.0068300 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-05-29 | 2018-05-29 - 2019-02-28 | LAPSED |
| 1489134 | 1.058432-RES | Resident Physician | 2015-07-01 | 2015-07-01 - 2018-06-30 | INACTIVE |
| Street Address | 6 HORIZON RD |
| City | FORT LEE |
| State | NJ |
| Zip Code | 07024-6652 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Richard D Levy | 6 Horizon Rd, Fort Lee, NJ 07024 | Dentist | 1993-09-23 ~ 1994-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eun Kim | 1263a Inwood Terrace, Fort Lee, NJ 07024 | Pharmacist | ~ |
| Stephen C Leventis | 2125 Center Ave Ste 301, Fort Lee, NJ 07024 | Architect | 2020-08-01 ~ 2021-07-31 |
| Taeik Kim | 2029 Lemoine Ave. Suite 302, Fort Lee, NJ 07024 | Architect | 2020-08-01 ~ 2021-07-31 |
| Catalina A Grigorescu | 270 Bluff Road, Fort Lee, NJ 07024 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shaina Rodrigues | 2461 8th Street, Fort Lee, NJ 07024 | Resident Physician | 2020-06-28 ~ 2021-06-30 |
| Daniel William Livshin | 3406 Crest Ln, Fort Lee, NJ 07024 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Robert Abraham | 296 Harmon Ave., Fort Lee, NJ 07024 | Radiographer | 2020-06-01 ~ 2021-05-31 |
| Marge Teilhaber | 555 North Avenue 6 T, Fort Lee, NJ 07024 | Notary Public Appointment | 2015-04-01 ~ 2020-03-31 |
| Andrew J Merin | 4 Ascot Way, Fort Lee, NJ 07024 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
| Seungjin Kim | 2050 Central Road Apt 718, Fort Lee, NJ 07024 | Dentist | 2020-02-20 ~ 2021-02-28 |
| Find all Licenses in zip 07024 | |||
| City | FORT LEE |
| Zip Code | 07024 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + FORT LEE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
| Arnold R Kriegstein | College Physician, New York, NY 10032 | Physician/surgeon | 1993-04-23 ~ 1994-03-31 |
| John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Brent Robert Jacobson | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Catherine Nguyen Keegan | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Nazanin Barzideh Md | North Shore Retina Physician, Pllc, East Hills, NY 11576 | Physician/surgeon | 2010-05-01 ~ 2011-04-30 |
| Barbara M Galko Md | Danbury Office of Physician Services PC, Danbury, CT 06810 | Physician/surgeon | 2010-06-01 ~ 2011-05-31 |
| Barbara A Brandes Md | Danbury Office of Physician Services, Danbury, CT 06810 | Physician/surgeon | 2004-07-08 ~ 2005-07-31 |
Please comment or provide details below to improve the information on DI SHI.
| 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).