ELIZABETH SIDERIDES (Credential# 548642) 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.
ELIZABETH SIDERIDES is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.030718. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 1351 Washington Blvd, Stamford, CT 06902. The current status is active.
| Licensee Name | ELIZABETH SIDERIDES |
| Credential ID | 548642 |
| Credential Number | 1.030718 |
| Credential Type | Physician/Surgeon |
| Business Address |
1351 Washington Blvd Stamford CT 06902 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1990-04-20 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-04-14 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 158695 | CSP.0018026 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 1351 Washington Blvd |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Katherine Vaillancourt | 1351 Washington Blvd, Stamford, CT 06902-2419 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Rosario Giacomini | 1351 Washington Blvd, Stamford, CT 06904 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Domenic Termine | 1351 Washington Blvd, Stamford, CT 06904 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Matthew Scott | 1351 Washington Blvd, Stamford, CT 06904 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Katherine Mathew | 1351 Washington Blvd, Stamford, CT 06904 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Optimus Health Care, Inc. | 1351 Washington Blvd, Stamford, CT 06902-2419 | Psychiatric Outpatient Clinic | 2019-07-01 ~ 2023-06-30 |
| Meghan Veno | 1351 Washington Blvd, Stamford, CT 06902-2419 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Emilie Leroy | 1351 Washington Blvd, Stamford, CT 06902-2419 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Shelja Patel | 1351 Washington Blvd, Stamford, CT 06902-2419 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Kristen Colavita | 1351 Washington Blvd, Stamford, CT 06902-2419 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeris Maydeli Flores | 153 Fairfield Av, Stamford, CT 06902 | Nail Technician | ~ |
| Reynaldo De La Cruz | 64 Brookside Drive, Stamford, CT 06902 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Darren J Petillo | 5 Hundley Court, Stamford, CT 06902 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Antonios Restaurant | 405 West Main St, Stamford, CT 06902 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Edward Smith | 184 Fairfield Ave., Stamford, CT 06902 | Home Improvement Contractor | ~ |
| Margaret A Dorrance | 24c Hamilton Court, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carolyn Maguire | 48 Nelson St, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Evelyne Joassin | 17 George St., Stamford, CT 06902 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Andrea Bynoe | 34 Melrose Pl, Stamford, CT 06902 | Notary Public Appointment | 1994-04-06 ~ 1999-04-30 |
| Ravi K Ahuja | 296 Westover Rd, Stamford, CT 06902 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06902 | |||
| City | STAMFORD |
| Zip Code | 06902 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + STAMFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cleo I Siderides | 103 Woods End Rd, New Canaan, CT 06840-4030 | Physician/surgeon | 2010-10-01 ~ 2011-09-30 |
| Nicole Caldwell | 240 Elizabeth St # H1-120, Elizabeth, CO 80107-7537 | Physician/surgeon | 2015-03-01 ~ 2016-02-29 |
| Frederick Lu | Po Box 546, Elizabeth, NJ 07207 | Physician/surgeon | 1994-05-06 ~ 1995-04-30 |
| Elizabeth Baorto | 360 3rd St Ste 425, San Francisco, CA 94107-2164 | Physician/surgeon | ~ |
| Elizabeth Kao | 4 Edenville Rd, Warwick, NY 10990-2419 | Physician/surgeon | 2017-10-01 ~ 2018-09-30 |
| Gary Leeds | 16 Elizabeth Ln, Riverside, CT 06878-1302 | Physician/surgeon | ~ |
| Elizabeth Y Lee | 37 Ridge Rd, Danbury, CT 06810-6362 | Physician/surgeon | 2016-12-13 ~ 2017-06-30 |
| Nina R Rivera | 141 Elizabeth St, Hartford, CT 06105-2211 | Physician/surgeon | ~ |
| Elizabeth Virginia-hartman | 92 Hix Ave, Rye, NY 10580-2450 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Elizabeth C Glass Md | 7 Dandy Dr, Cos Cob, CT 06807-2204 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
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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).