PHILIP T GOLDENBERG MD (Credential# 152971) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 3, 2004. The license expiration date date is February 28, 2005. The license status is INACTIVE.
PHILIP T GOLDENBERG MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0005376. The credential type is controlled substance registration for practitioner. The effective date is March 3, 2004. The expiration date is February 28, 2005. The business address is 705 Bloomfield Ave, Bloomfield, CT 06002. The current status is inactive.
| Licensee Name | PHILIP T GOLDENBERG MD |
| Credential ID | 152971 |
| Credential Number | CSP.0005376 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
705 Bloomfield Ave Bloomfield CT 06002 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 2004-03-03 |
| Expiration Date | 2005-02-28 |
| Refresh Date | 2009-01-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 538753 | 1.006898 | Physician/Surgeon | 1952-03-10 | 2003-07-28 - 2004-08-31 | INACTIVE |
| 172809 | CSP.0024291 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1997-03-01 - 1998-02-28 | INACTIVE |
| Street Address | 705 BLOOMFIELD AVE |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Scott M Kallor Do | 705 Bloomfield Ave, Bloomfield, CT 06002 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Jeanne L Crockford Aprn | 705 Bloomfield Ave, Bloomfield, CT 06002 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Kristen P Capelli Pa | 705 Bloomfield Ave, Bloomfield, CT 06002 | Physician Assistant | 2002-07-22 ~ 2003-09-30 |
| Joseph I Ungar | 705 Bloomfield Ave, Bloomfield, CT 06002 | Physician/surgeon | 2000-03-02 ~ 2001-04-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paula L Raines | 92 Daniel Blvd, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Kesone Taletia Telfer | 36 Walsh Street, Bloomfield, CT 06002 | Advanced Practice Registered Nurse | ~ |
| Joan Zito Upton | 106 Duncaster Road, Bloomfield, CT 06002 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Sheri M Sparks | Primary Eye Care Center, Bloomfield, CT 06002 | Optometrist | 2020-09-01 ~ 2021-08-31 |
| Kaman Aerospace Corporation | Old Windsor Road, Bloomfield, CT 06002 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Healing Meals Foundation Corporation | Po Box 7223, Bloomfield, CT 06002 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Taylor A West | 5 Tiffany Ln, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Emma J Ranel | 53 Burr Road, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Dorothy W Field | 177 Oliver Way, Bloomfield, CT 06002 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Carol J Mortensen | 6 Maple Edge Dr, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06002 | |||
| City | BLOOMFIELD |
| Zip Code | 06002 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BLOOMFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Diana Goldenberg | 10 Stonewall Lane, Mamaroneck, NY 10543 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Matthew N. Goldenberg | 184 Liberty Street, New Haven, CT 06519-1625 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Steven A Goldenberg Md · Attn Sue | 263 Farmington Ave, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Philip Y Wai | 100 Temple St Apt 202, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2006-03-28 ~ 2007-02-28 |
| Philip A Frick | Po Box 719, Niantic, CT 06357-0719 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Philip G Ong | 267 Grant St, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Philip J Lahey | 950 48th St Apt 7j, Brooklyn, NY 11219-2918 | Controlled Substance Registration for Practitioner | 2010-03-09 ~ 2011-02-28 |
| Simi A Philip | 14 Millbrook Ave, Tarrytown, NY 10591 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Philip J Mcwhorter Md | 5 Perryridge Rd., Greenwich, CT 06830 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Philip L Fava II | 222 Castlewood Dr, Bloomfield, CT 06002-1370 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
Please comment or provide details below to improve the information on PHILIP T GOLDENBERG MD.
| 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).