GEORGE SPIVACK MD (Credential# 546560) is licensed (Physician/surgeon) 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.
GEORGE SPIVACK MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.027399. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is Consulting Cardiologists, PC, Wallingford, CT 06492-6012. The current status is active.
| Licensee Name | GEORGE SPIVACK MD |
| Business Name | INTERNAL MEDICINE ASSOCIATES, P.C. |
| Credential ID | 546560 |
| Credential Number | 1.027399 |
| Credential Type | Physician/Surgeon |
| Business Address |
Consulting Cardiologists, PC Wallingford CT 06492-6012 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1986-07-01 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 155152 | CSP.0014309 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Business ID | 0023574 |
| Business Name | INTERNAL MEDICINE ASSOCIATES, P.C. |
| Business Address | ATTENTION: ACCOUNTS PAYABLE, 67 MASONIC AVENUE, SUITE 3100, WALLINGFORD, CT, 06492 |
| Mailing Address | ATTENTION: ACCOUNTS PAYABLE, 67 MASONIC AVENUE, SUITE 3100, WALLINGFORD, CT, 06492 |
| Registration Date | 1968-05-31 |
| State Citizenship | Domestic/CT |
| Business Type | Stock |
| Business Status | Dissolved |
| Agent Name | JOSEPH T. TOMANELLI |
| Agent Business Address | 67 MASONIC AVE., STE. 3100, WALLINGFORD, CT, 06492 |
| Street Address | Consulting Cardiologists, PC |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492-6012 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Craig M Keanna | 1062 Barnes Rd, Wallingford, CT 06492-6012 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrea Zola | 53 Alison Ave., Wallingford, CT 06492 | Esthetician | ~ |
| Kyungok Choi | 90 Ward St, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Giang Nguyen | 45 Country Club Lane, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-11-30 |
| Lc Artistry | 207 North Colony Road, Wallingford, CT 06492 | Esthetician | ~ |
| Katie Lee | 20 Angela Dr, Wallingford, CT 06492 | Paramedic | 2020-09-01 ~ 2021-08-31 |
| Vinny's Deli | 567 Center St, Wallingford, CT 06492 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Michele Ruggiero | 26 Leigus Road, Wallingford, CT 06492 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Dianna K Ball | 104 Simpson Ave, Wallingford, CT 06492 | Speech and Language Pathologist | 2020-08-01 ~ 2021-07-31 |
| Ann Marie Richardson | 20 Mohawk Drive, Wallingford, CT 06492 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Joann Hummel | 60 Deer Run Road, Wallingford, CT 06492 | Medication Administration Certification | 2018-08-21 ~ 2020-08-20 |
| Find all Licenses in zip 06492 | |||
| City | WALLINGFORD |
| Zip Code | 06492 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WALLINGFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven C Lieu Do | Somerset Internal Medicine, Glastonbury, CT 06033-1076 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Neera K Dahl Md | Dept of Internal Medicine, New Haven, CT 06520-8029 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Michael P Steinberg Md | Internal Medicine Assocs, Farmington, CT 06030-6245 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Nava Nasr | Department of Internal Medicine, Waterbury, CT 06706 | Physician/surgeon | 2010-09-01 ~ 2011-08-31 |
| R Scott Borrus Md | Southern Connecticut Internal Medicine P.C., New Haven, CT 06511 | Physician/surgeon | 2007-12-17 ~ 2009-02-28 |
| Catharine A Arnold Md | Guilford Internal Medicine, Guilford, CT 06437 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Michael L Sher Md | C/o G I & Internal Medicine of Orange, Orange, CT 06477 | Physician/surgeon | 2005-10-03 ~ 2006-10-31 |
| John P Hayslett Md · Yale Dept of Internal Medicine | Yale Dept of Internal Medicine, New Haven, CT 06520-8029 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Irving Shiffman Md · Internal Medicine Associates, P.C. | 3 Iron Forge, Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2004-02-29 ~ 2005-02-28 |
| Norry Lan Md · Internal Medicine Associates P C | Va Outpatient Clinic, French Camp, CA 95231 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).