WISSAM MANSOUR (Credential# 2037148) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
WISSAM MANSOUR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.065279-RES. The credential type is resident physician. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 100 Hickory Ave, Staten Island, NY 10305-4416. The current status is active.
| Licensee Name | WISSAM MANSOUR |
| Credential ID | 2037148 |
| Credential Number | 1.065279-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
100 Hickory Ave Staten Island NY 10305-4416 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2020-07-01 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-12 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 2041983 | CSP.0073880 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2020-05-04 | 2020-05-04 - 2021-02-28 | ACTIVE |
| Street Address | 100 HICKORY AVE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10305-4416 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jerry Cammarata | 185 Maryland Ave, Staten Island, NY 10305 | Speech and Language Pathologist | 2020-04-01 ~ 2021-03-31 |
| Christine Xt Zhu | 65 Alex Circle, Staten Island, NY 10305 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Greg E Voccola | 5083 Rathbun Rd, Cazenovia, NY 10305 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Joseph Early | 559 Nugent Avenue, Staten Island, NY 10305 | Physician Assistant | 2019-10-11 ~ 2020-10-31 |
| Mohammad Saeed | 18 Father Capodanno Blvd, Staten Island, NY 10305 | Tax Preparer/facilitator Permit | 2019-01-02 ~ 2021-01-31 |
| Sunila Mehrotra | 390 Maryland Avenue, #3a, Staten Island, NY 10305 | Physician/surgeon | 1978-03-28 ~ 1982-10-31 |
| Salah Eldin Mohamed | 110 Belair Road, Staten Island, NY 10305 | Physician/surgeon | 2017-02-15 ~ 2017-10-31 |
| Monika Peters | 495 Clifton Ave, Staten Island, NY 10305 | Registered Nurse - Temporary | 2017-09-15 ~ 2018-01-12 |
| Maria I Sola | 43 Xenia Street, Staten Island, NY 10305 | Master's Level Social Worker | 2015-03-04 ~ 2016-03-31 |
| Ronald S Lopes | 36 Bella Vista Court, Staten Island, NY 10305 | Home Inspector | 2014-03-19 ~ 2015-06-30 |
| Find all Licenses in zip 10305 | |||
| City | STATEN ISLAND |
| Zip Code | 10305 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + STATEN ISLAND |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mena Mansour | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2016-08-01 ~ 2020-06-30 |
| Wissam El Zein · Wissam & Son | 54 Hope St, Niantic, CT 06357 | Home Improvement Contractor | 2020-03-13 ~ 2020-11-30 |
| Mansour R Almnajam | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
| Wissam M F Chatila | 102b East Broadway, Milford, CT 06460 | Physician/surgeon | 1994-08-02 ~ 1995-09-30 |
| Mansour Developers Inc | 32 Huckleberry Hill Rd, Avon, CT 06001 | New Home Construction Contractor | 2017-10-01 ~ 2019-09-30 |
| Mansour Devopers Inc | 32-a Huckleberry Hill Rd, Avon, CT 06001 | Home Improvement Contractor | 2018-12-01 ~ 2019-11-30 |
| Mansour Prime Properties LLC | 32a Huckleberry Hill Rd, Avon, CT 06001-3178 | New Home Construction Contractor | 2019-09-09 ~ 2021-09-30 |
| Mansour Designer Pool LLC | 32 Huckleberry Hill, Avon, CT 06001 | Home Improvement Contractor | 2006-12-01 ~ 2007-11-30 |
| Victoria T Mansour | 115 Franklin Turnpike, Mahwah, NJ 07430 | Physician/surgeon | 2004-06-07 ~ 2005-06-30 |
| Ashraf H Mansour | 64 Travis Ave, Staten Island, NY 10314 | Physician/surgeon | 2003-11-25 ~ 2004-04-30 |
Please comment or provide details below to improve the information on WISSAM MANSOUR.
| 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).