WARREN R PISTEY MD PHD
Physician/surgeon


Address: 645 Redding Rd, Fairfield, CT 06824

WARREN R PISTEY MD PHD (Credential# 541124) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2011. The license expiration date date is June 30, 2012. The license status is INACTIVE.

Business Overview

WARREN R PISTEY MD PHD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.014476. The credential type is physician/surgeon. The effective date is July 1, 2011. The expiration date is June 30, 2012. The business address is 645 Redding Rd, Fairfield, CT 06824. The current status is inactive.

Basic Information

Licensee Name WARREN R PISTEY MD PHD
Credential ID 541124
Credential Number 1.014476
Credential Type Physician/Surgeon
Business Address 645 Redding Rd
Fairfield
CT 06824
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1970-06-25
Effective Date 2011-07-01
Expiration Date 2012-06-30
Refresh Date 2012-10-05

Other licenses

ID Credential Code Credential Type Issue Term Status
408107 CSP.0037659 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2005-06-24 2008-03-01 - 2009-02-28 INACTIVE

Office Location

Street Address 645 REDDING RD
City FAIRFIELD
State CT
Zip Code 06824

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Competitor

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City FAIRFIELD
Zip Code 06824
License Type Physician/Surgeon
License Type + County Physician/Surgeon + FAIRFIELD

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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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