JACK M DODICK
Physician/surgeon


Address: 535 Park Ave, New York, NY 10021

JACK M DODICK (Credential# 543425) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 26, 2018. The license expiration date date is March 31, 2019. The license status is INACTIVE.

Business Overview

JACK M DODICK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.020654. The credential type is physician/surgeon. The effective date is April 26, 2018. The expiration date is March 31, 2019. The business address is 535 Park Ave, New York, NY 10021. The current status is inactive.

Basic Information

Licensee Name JACK M DODICK
Credential ID 543425
Credential Number 1.020654
Credential Type Physician/Surgeon
Business Address 535 Park Ave
New York
NY 10021
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1978-08-10
Effective Date 2018-04-26
Expiration Date 2019-03-31
Refresh Date 2019-07-04

Office Location

Street Address 535 PARK AVE
City NEW YORK
State NY
Zip Code 10021

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Anuj Malhotra 429 East 75th St, 5th Floor, New York, NY 10021 Physician/surgeon ~
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Katherine Nicole Day 310 E 71st Street, New York, NY 10021 Registered Nurse ~
Jordan D Metzl Md Hospital for Special Surgery, New York, NY 10021 Physician/surgeon 2020-07-01 ~ 2021-06-30
Lisa F Schneider 820 Park Avenue, New York, NY 10021 Physician/surgeon 2020-09-01 ~ 2021-08-31
Ryan C Ciambriello 423 E 73rd St. Apt 2d, New York, NY 10021 Real Estate Salesperson 2020-06-01 ~ 2021-05-31
Maxxwell S Crowley 315 East 73 Rd Street Apt #4, New York, NY 10021 Real Estate Salesperson 2020-06-01 ~ 2021-05-31
Jean P Simon 36 E 70 Th Street, New York, NY 10021 Physician/surgeon 2020-07-01 ~ 2021-06-30
Todd James Albert 541 East 71st Street, New York, NY 10021 Physician/surgeon 2020-07-01 ~ 2021-06-30
Russell F Warren Md 535 East 70th St, New York, NY 10021 Physician/surgeon 2020-07-01 ~ 2021-06-30
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City NEW YORK
Zip Code 10021
License Type Physician/Surgeon
License Type + County Physician/Surgeon + NEW YORK

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Jack F Wilder 363 Shore Rd, Greenwich, CT 06830 Physician/surgeon 1998-01-30 ~ 1999-01-31
Jack Zweig 145 Vaneck Dr., New Rochelle, NY 10804 Physician/surgeon 1967-09-18 ~ 1982-06-30
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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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