VARSHITHA P THANIKONDA (Credential# 1526325) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is June 28, 2018. The license expiration date date is June 30, 2021. The license status is ACTIVE.
VARSHITHA P THANIKONDA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.061492-RES. The credential type is resident physician. The effective date is June 28, 2018. The expiration date is June 30, 2021. The business address is 263 Farmington Ave # Mc1921, Farmington, CT 06030-0001. The current status is active.
| Licensee Name | VARSHITHA P THANIKONDA |
| Credential ID | 1526325 |
| Credential Number | 1.061492-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
263 Farmington Ave # Mc1921 Farmington CT 06030-0001 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-06-28 |
| Effective Date | 2018-06-28 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2018-07-12 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1529565 | CSP.0068995 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-07-11 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 263 FARMINGTON AVE # MC1921 |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-0001 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alfredo Garcia | 263 Farmington Ave # Mc1921, Farmington, CT 06030-0001 | Resident Physician | 2018-06-28 ~ 2021-06-30 |
| Jacqueline S Nissen | 263 Farmington Ave # Mc1921, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Daniel M Guevara-pineda | 263 Farmington Ave # Mc1921, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hanxiang A Wang | 263 Farmington Ave # Mc1921, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Meghan E Snuckel | 263 Farmington Ave # Mc1921, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Subtain A Zia | 263 Farmington Ave # Mc1921, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jordan A Borgman | 263 Farmington Ave # Mc1921, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Komalben Pravinbhai Parmar | 263 Farmington Ave # Mc1921, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Wendy A Miller | Mc1921 Farmington Ave # 263, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jason J Ziegler | 2 Courthouse Square, Farmington, CT 06030-0001 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Bryden T Considine | L2104 of Medicine Rm, Farmington, CT 06030-0001 | Resident Physician | 2017-07-03 ~ 2021-06-30 |
| Dillon Paulo | 4260 Cordoba Ct, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Erica Shen Nofziger | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2027-06-30 |
| Omar Ibrahim | 263 Farmington Ave # Mc-1321, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jillian L Fortier | Uconn Health Center, Department of Surgery, Farmington, CT 06030-0001 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Douglas Zelisko | 263 Farmington Ave Dept Of, Farmington, CT 06030-0001 | Physician/surgeon | 2020-04-23 ~ 2021-01-31 |
| Ruchir D Trivedi | 263 Farmington Ave # Mc-1405, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Rawan J.j. Sarsour | 263 Farmington Ave # Mc3905, Farmington, CT 06030-0001 | Provisional Faculty Dentist | 2020-04-21 ~ 2021-04-30 |
| Find all Licenses in zip 06030-0001 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | FARMINGTON |
| Zip Code | 06030 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Yan Zhu | 27 Brainerd Rd # B, Branford, CT 06405-6302 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Jennifer A Guy | 6 Early Dr Apt K, Watervliet, NY 12189-2517 | Resident Physician | ~ |
| Victoria Parker | CT | Resident Physician | 2015-06-23 ~ 2021-06-30 |
| Jia Wei Tan | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Tao Zuo | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2016-07-25 ~ 2020-06-30 |
| Jin Woo Yoo | 44 Orange St Apt 317, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Gin Yi Lee | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2019-06-20 ~ 2022-06-30 |
| Brittany N Davis | 7 4th St Apt 3b, Stamford, CT 06905-5008 | Resident Physician | 2017-07-01 ~ 2022-06-30 |
| Eni Smith | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2018-09-17 ~ 2019-06-30 |
| Gino J Mongelluzzo | 213 W 3rd St, Bloomsburg, PA 17815 | Resident Physician | 2015-06-25 ~ 2019-06-30 |
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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).