THEODORE D FISHMAN MD (Credential# 545599) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
THEODORE D FISHMAN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.025703. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 670 Prospect Ave, Hartford, CT 06105. The current status is active.
| Licensee Name | THEODORE D FISHMAN MD |
| Credential ID | 545599 |
| Credential Number | 1.025703 |
| Credential Type | Physician/Surgeon |
| Business Address |
670 Prospect Ave Hartford CT 06105 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1984-07-02 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-03-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 150851 | CSP.0012867 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 670 PROSPECT AVE |
| City | HARTFORD |
| State | CT |
| Zip Code | 06105 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Joyce R Kamanitz | 670 Prospect Ave, Hartford, CT 06105 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Hartford Community Loan Fund | 215 Garden Street, Hartford, CT 06105 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Kathleen C Hobart | 81 Fern Street, Hartford, CT 06105 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Khadija Seidi | 196 Laurel St, Hartford, CT 06105 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Stuart W Alpert | 200 N Beacon St, Hartford, CT 06105 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Christina Perez | 4 Atwood Street, Hartford, CT 06105 | Marital and Family Therapist | 2020-07-01 ~ 2021-06-30 |
| Ashley Ameena Bachan | 25 Owen Street, Hartford, CT 06105 | Licensed Practical Nurse | 2020-06-01 ~ 2021-05-31 |
| Dhruti Anilkant Mankodi | Hospitalist Department, Hartford, CT 06105 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Jacqueline Alexandra Raymond | 24 Owen Street, Hartford, CT 06105 | Esthetician | 2020-06-22 ~ 2021-10-31 |
| Hortense Bates | 48-50 Atwood Street, Hartford, CT 06105 | Medication Administration Certification | 2020-08-20 ~ 2022-08-19 |
| Nicolas Archambault | 169 Sigourney Street, Hartford, CT 06105 | Emergency Medical Technician | ~ |
| Find all Licenses in zip 06105 | |||
| City | HARTFORD |
| Zip Code | 06105 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert F Fishman | 11 Cardinal Ln, Westport, CT 06880-1714 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Felicity G Fishman | 2160 S 1st Ave, Maywood, IL 06153 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Fred L Fishman | 333 Birchwood Ave, Deerfield, IL 60015-4714 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Henry J Fishman | 2141 K St Nw, Washington, DC 20037 | Physician/surgeon | 1999-09-24 ~ 2000-09-30 |
| Ronald S Fishman Md | 3 Bay Hill Drive, Bloomfield, CT 06002 | Physician/surgeon | 2016-09-01 ~ 2017-08-31 |
| Stephen D Fishman | 3 Northcliff Dr, West Hartford, CT 06117 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Eric Fishman | 53 Penn Boulevard, Scarsdale, NY 10583 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia M Fishman | 10243 S. Seeley Ave., Chicago, IL 60643-2038 | Physician/surgeon | 2005-07-28 ~ 2006-07-31 |
| Gary R Fishman | 1969 West 5th Street, Brooklyn, NY 11223 | Physician/surgeon | 2007-10-04 ~ 2008-10-31 |
| Eina G Fishman | 27708 Water Ash Dr, Wesley Chapel, FL 33544-8752 | Physician/surgeon | 2018-07-01 ~ 2019-06-30 |
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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).