MARIAM TSIKVADZE
Resident Physician


Address: 263 Farmington Avenue, Farmington, CT 06030-1921

MARIAM TSIKVADZE (Credential# 1526330) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is June 28, 2018. The license expiration date date is July 27, 2018. The license status is INACTIVE.

Business Overview

MARIAM TSIKVADZE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.061497-RES. The credential type is resident physician. The effective date is June 28, 2018. The expiration date is July 27, 2018. The business address is 263 Farmington Avenue, Farmington, CT 06030-1921. The current status is inactive.

Basic Information

Licensee Name MARIAM TSIKVADZE
Credential ID 1526330
Credential Number 1.061497-RES
Credential Type Resident Physician
Credential SubCategory RES
Business Address 263 Farmington Avenue
Farmington
CT 06030-1921
Business Type INDIVIDUAL
Status INACTIVE - INACTIVE
Issue Date 2018-06-28
Effective Date 2018-06-28
Expiration Date 2018-07-27
Refresh Date 2018-07-27

Other locations

Licensee Name Office Address Credential Effective / Expiration
Mariam Tsikvadze 263 Farmington Ave, Farmington, CT 06030-0001 Resident Physician 2018-06-28 ~ 2022-06-30

Office Location

Street Address 263 Farmington Avenue
City Farmington
State CT
Zip Code 06030-1921

Licenses in the same location

Licensee Name Office Address Credential Effective / Expiration
Davis Aasen 263 Farmington Avenue, Farmington, CT 06030-1921 Resident Physician 2020-07-01 ~ 2025-06-30
Christopher D Lemoine 263 Farmington Avenue, Farmington, CT 06030-1921 Resident Physician 2020-07-01 ~ 2025-06-30
Dylan Buller 263 Farmington Avenue, Farmington, CT 06030-1921 Resident Physician 2020-07-01 ~ 2025-06-30
Jennifer Lindelof 263 Farmington Avenue, Farmington, CT 06030-1921 Resident Physician 2020-07-01 ~ 2025-06-30
Colin J Pavano 263 Farmington Avenue, Farmington, CT 06030-1921 Resident Physician 2020-07-01 ~ 2025-06-30
Barrett B Torre 263 Farmington Avenue, Farmington, CT 06030-1921 Resident Physician 2020-07-01 ~ 2025-06-30
Samantha Slattery 263 Farmington Avenue, Farmington, CT 06030-1921 Resident Physician 2020-07-01 ~ 2025-06-30
Ethan A Miller 263 Farmington Avenue, Farmington, CT 06030-1921 Resident Physician 2020-06-28 ~ 2024-06-30
Patrick Bergamo 263 Farmington Avenue, Farmington, CT 06030-1921 Resident Physician 2020-06-28 ~ 2024-06-30
Shriya Gupta 263 Farmington Avenue, Farmington, CT 06030-1921 Resident Physician 2020-06-28 ~ 2024-06-30
Find all Licenses in the same address

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Hady Eltayeby 263 Farmington Avenue, Ct, Farmington, CT 06030-1921 Controlled Substance Registration for Practitioner ~
Hassaan Aftab 263 Farmington Ave, Farmington, CT 06030-1921 Resident Physician 2019-07-01 ~ 2021-06-30
Adriana Kahn 263 Farmington Ave, Farmington, CT 06030-1921 Resident Physician 2018-06-28 ~ 2021-06-30
Shinya U. Amano 263 Farmington Ave, Farmington, CT 06030-1921 Resident Physician 2019-05-23 ~ 2019-06-06
Mathur Prateek 263 Farmington Ave, Farmington, CT 06030-1921 Resident Physician 2019-01-02 ~ 2019-01-24
Kenneth Aguirre 263 Farmington Ave, Farmington, CT 06030-1921 Resident Physician 2018-11-08 ~ 2018-11-17
Nick M Feo 263 Farmington Ave, Farmington, CT 06030-1921 Resident Physician 2018-10-01 ~ 2018-10-14
Rabeea Nazir 263 Farmington Ave, Farmington, CT 06030-1921 Resident Physician 2018-09-30 ~ 2018-10-13
Jacob Jabbour 263 Farmington Ave, Farmington, CT 06030-1921 Resident Physician 2018-09-17 ~ 2018-09-28
Natalie Godfrey 263 Farmington Ave, Farmington, CT 06030-1921 Resident Physician 2018-08-13 ~ 2018-08-24
Find all Licenses in zip 06030-1921

Licenses in the same zip code

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

Competitor

Search similar business entities

City Farmington
Zip Code 06030
License Type Resident Physician
License Type + County Resident Physician + Farmington

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Dataset Information

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).

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