KSENIYA KHMARA (Credential# 1636743) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2020. The license expiration date date is August 31, 2021. The license status is ACTIVE.
KSENIYA KHMARA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.064068. The credential type is physician/surgeon. The effective date is September 1, 2020. The expiration date is August 31, 2021. The business address is 100 Retreat Ave, Hartford, CT 06102-8000. The current status is active.
| Licensee Name | KSENIYA KHMARA |
| Credential ID | 1636743 |
| Credential Number | 1.064068 |
| Credential Type | Physician/Surgeon |
| Business Address |
100 Retreat Ave Hartford CT 06102-8000 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-08-06 |
| Effective Date | 2020-09-01 |
| Expiration Date | 2021-08-31 |
| Refresh Date | 2020-06-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1681911 | CSP.0072190 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-08-07 | 2019-08-07 - 2021-02-28 | ACTIVE |
| Street Address | 100 Retreat Ave |
| City | HARTFORD |
| State | CT |
| Zip Code | 06102-8000 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lara Addesso | 100 Retreat Ave, Hartford, CT 06106 | Resident Physician | 2020-07-01 ~ 2022-06-30 |
| Kevin Sean Elliott | 100 Retreat Ave, Hartford, CT 06106-2528 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Evan J Burke | 100 Retreat Ave, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-04-01 ~ 2021-02-28 |
| Jonathan H Tress | 100 Retreat Ave, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| David A Kvam | 100 Retreat Ave, Hartford, CT 06106-2565 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael T Lawlor | 100 Retreat Ave, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Justine F. Miranda | 100 Retreat Ave, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Emily J Rosenbush Md | 100 Retreat Ave, Hartford, CT 06106-2528 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sidra Azim | 100 Retreat Ave, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Maritza Montanez | 100 Retreat Ave, Hartford, CT 06016 | Physician/surgeon | 2020-04-02 ~ 2020-07-31 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mohammad I Alshelleh | 80 Seymour St Ste 502, Hartford, CT 06102-8000 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Konstadina Darsaklis | 85 Jefferson Street (jefferson Building), Hartford, CT 06102-8000 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Peter Paul Yu | 195 Retreat Avenue, Hartford, CT 06102-8000 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Pragya Kalla | 80 Seymour St, Hartford, CT 06102-8000 | Resident Physician | 2019-07-01 ~ 2023-06-30 |
| Besiana L Liti | 80 Seymour St Bldg 217, Hartford, CT 06102-8000 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Aparna Vaddiparti | 80 Seymour St # Jb604, Hartford, CT 06102-8000 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hema D. Brazell Md | 85 Seymour St Mob 525, Hartford, CT 06102-8000 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Mark W Sebastian Md | 80 Seymour St # Cb-136, Hartford, CT 06102-8000 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Nicole G Baarck | 80 Seymour St, Hartford, CT 06102-8000 | Resident Physician | 2019-07-01 ~ 2023-06-30 |
| Ignatius Ang | 80 Seymour St, Hartford, CT 06102-8000 | Resident Physician | 2019-07-01 ~ 2023-06-30 |
| Find all Licenses in zip 06102-8000 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sivabalaji Kaliamurthy | 80 Seymour Street, Hartford, CT 06102 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Erica S Hammer | 85 Jefferson Ave Ste 625, Hartford, CT 06102 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Joseph A Digiuseppe | Dept of Pathology, Hartford, CT 06102 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Joseph V Portereiko Do | Hartford Hospital : Department of Surgery, Hartford, CT 06102 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Vasanthy Thevarajah | Hardfort Hospital, Hartford, CT 06102 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Elaine Manson | 135 Dapex, Hartford, CT 06102 | Medication Administration Certification | ~ |
| Valridine Durrant | 2718 Main St, Hartford, CT 06102 | Medication Administration Certification | 2020-03-08 ~ 2022-03-07 |
| Jennifer Susan Thran | 80 Seymore St, Hartford, CT 06102 | Registered Nurse | ~ |
| Monique M Vaughan | 401 Granby Street, Hartford, CT 06102 | Real Estate Salesperson | ~ |
| Bruce M Kaplan Md | Hartford Hospital Gray Cancer Center, Hartford, CT 06102 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Find all Licenses in zip 06102 | |||
| City | HARTFORD |
| Zip Code | 06102 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kseniya Golubets · Kseniya | 123 York St Apt 5l, New Haven, CT 06511-5621 | Controlled Substance Registration for Practitioner | 2011-07-20 ~ 2013-02-28 |
| Kseniya Slobodyanyuk | 20 York Street, New Haven, CT 06510 | Resident Physician | 2017-07-01 ~ 2018-06-30 |
| Kseniya Marsyukova | 4216 Oneida Ave Apt 7c, Bronx, NY 10470-2149 | Registered Nurse | 2017-09-01 ~ 2018-08-31 |
| Kseniya Slobodyanyuk | 111 Park St Apt 14p, New Haven, CT 06511-5466 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| 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 |
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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).