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.
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.
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 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Mariam Tsikvadze | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2018-06-28 ~ 2022-06-30 |
Street Address | 263 Farmington Avenue |
City | Farmington |
State | CT |
Zip Code | 06030-1921 |
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 |
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 |
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 |
---|---|---|---|
Mariam Avetisova | 321 Hayden St Apt D, Sayre, PA 18840-1623 | Physician/surgeon | ~ |
Mariam Farhan | 76 Tyler Hill Rd, Naugatuck, CT 06770-3193 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Ankur Gupta | 10835 Mariam Ln, Dayton, OH 45458 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
Ghousia Mariam Alikhan | 100 Barron Circle, Somerset, NJ 08873 | Physician/surgeon | 2017-09-08 ~ 2018-02-28 |
Mariam Sofia Aboian | 3 Marion Lane, Woodbridge, CT 06525 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Mariam Hasan | 15891 Los Gatos Almaden Rd, Los Gatos, CA 95032 | Physician/surgeon | ~ |
Mariam Khan | 235 E 46th St Apt 4j, New York, NY 10017-2920 | Dentist | 2019-09-11 ~ 2020-07-31 |
Mariam Hanna | 653 Laurel Ave, Holmdel, NJ 07733-1003 | Pharmacist | 2014-02-01 ~ 2016-01-31 |
Mariam Kaouachi | A-7506 Lesage, Lasalle, QC H8N2T3 | Registered Nurse | ~ |
Mariam Serebour | 94 Cambridge St, Manchester, CT 06042-3508 | Pharmacy Technician | 2011-04-01 ~ 2012-03-31 |
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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).