DAVID EZRA MANDELBAUM
Physician/surgeon


Address: 237 Irving Ave, Providence, RI 02906-5518

DAVID EZRA MANDELBAUM (Credential# 1659279) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2019. The license expiration date date is October 31, 2020. The license status is ACTIVE.

Business Overview

DAVID EZRA MANDELBAUM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.064335. The credential type is physician/surgeon. The effective date is October 1, 2019. The expiration date is October 31, 2020. The business address is 237 Irving Ave, Providence, RI 02906-5518. The current status is active.

Basic Information

Licensee Name DAVID EZRA MANDELBAUM
Credential ID 1659279
Credential Number 1.064335
Credential Type Physician/Surgeon
Business Address 237 Irving Ave
Providence
RI 02906-5518
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2019-10-01
Effective Date 2019-10-01
Expiration Date 2020-10-31
Refresh Date 2019-10-03

Office Location

Street Address 237 IRVING AVE
City PROVIDENCE
State RI
Zip Code 02906-5518

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
The Stephen C. Rose Legacy Foundation · The Steve Fund 138 Governor Street, Providence, RI 02906 Public Charity 2020-06-12 ~ 2021-11-30
Moriah Connor 211 Waterman Street, Unit 20, Providence, RI 02906 Behavior Analyst ~
Elizabeth Burns 198 Camp Street, Providence, RI 02906 Licensed Clinical Social Worker ~
Christine Montross 345 Blackstone Blvd, Providence, RI 02906 Physician/surgeon 2020-09-01 ~ 2021-08-31
Susan Dickstein 196 Freeman Parkway, Providence, RI 02906 Psychologist 2020-07-01 ~ 2021-06-30
Victoria S Karlsen 415 Angell St, Providence, RI 02906 Behavior Analyst ~
John W O'bell Md 14 Rose Ct., Providence, RI 02906 Physician/surgeon 2020-06-01 ~ 2021-05-31
Alexandria Hanul Simon 323 Angell Street, Providence, RI 02906 Emergency Medical Technician ~
Molly A Moran 202 Sixth Street, Providence, RI 02906 Advanced Practice Registered Nurse 2020-06-01 ~ 2021-05-31
Simon M Cornelissen 45 Balton Rd, Providence, RI 02906 Physician/surgeon 2020-05-01 ~ 2021-04-30
Find all Licenses in zip 02906

Competitor

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City PROVIDENCE
Zip Code 02906
License Type Physician/Surgeon
License Type + County Physician/Surgeon + PROVIDENCE

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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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