STEPHANIE N SUDIKOFF MD (Credential# 552199) 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.
STEPHANIE N SUDIKOFF MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.034603. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 72 Old Dike Rd, Trumbull, CT 06611-3310. The current status is active.
| Licensee Name | STEPHANIE N SUDIKOFF MD |
| Credential ID | 552199 |
| Credential Number | 1.034603 |
| Credential Type | Physician/Surgeon |
| Business Address |
72 Old Dike Rd Trumbull CT 06611-3310 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1995-06-23 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-05-21 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 499170 | CSP.0043323 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-05-20 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 161140 | CSP.0023340 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1997-03-01 - 1998-02-28 | INACTIVE |
| Street Address | 72 OLD DIKE RD |
| City | TRUMBULL |
| State | CT |
| Zip Code | 06611-3310 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Natalia Faraldi | 72 Old Dike Rd, Trumbull, CT 06611-3310 | Registered Nurse | 2017-12-01 ~ 2018-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Emily Bietsch | 62 Old Dike Rd, Trumbull, CT 06611-3310 | Physical Therapist | 2020-07-01 ~ 2021-06-30 |
| Therese M Evans | 94 Old Dike Rd, Trumbull, CT 06611-3310 | Real Estate Salesperson | 2011-06-30 ~ 2012-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ashley S Balestriere | 7 Sutton Place, Trumbull, CT 06611 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Filomena L Ferraro · Nicolia | 35 Skating Pond Rd, Trumbull, CT 06611 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Alexis Grace Shaub | 58 Chestnut Hill Road, Trumbull, CT 06611 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Maria Bivona | 5302 Main Street, Trumbull, CT 06611 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Gina M Gallo · Liquigli | 20 Red Maple Lane, Trumbull, CT 06611 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Xuehuan Zhang | 31 Asbury Rd, Trumbull, CT 06611 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Antoinette D Senior | 38 Tanager Lane, Trumbull, CT 06611 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Solution Construction LLC | 3 Stonewall Lane, Trumbull, CT 06611 | New Home Construction Contractor | 2020-06-18 ~ 2021-09-30 |
| Gary T Sorge | 63 Limerick Road, Trumbull, CT 06611 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Melodie T Noga | 55 Moose Hill Road, Trumbull, CT 06611 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
| Find all Licenses in zip 06611 | |||
| City | TRUMBULL |
| Zip Code | 06611 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + TRUMBULL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stephanie V Ng | 168 Linden St, Apt C2, New Haven, CT 06511 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Stephanie A Salas | 450 W 42nd St Apt 38h, New York, NY 10036-8213 | Physician/surgeon | ~ |
| Stephanie Green Md | 2 Fox Den Way, Woodbridge, CT 06525 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Stephanie L Kwei Md | Boardman 330, New Haven, CT 06520 | Physician/surgeon | 2016-10-01 ~ 2017-09-30 |
| Stephanie M Brian Md | 92 Steeplechase Dr, Media, PA 19063-1975 | Physician/surgeon | 2016-05-01 ~ 2017-04-30 |
| Stephanie J Saucier | 246 Richard St, Newington, CT 06111 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Stephanie Leeds | 39 Midbrook Ln, Old Greenwich, CT 06870-1427 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Stephanie A Garozzo | 1 Grove St Fl 2, New Britain, CT 06053-4116 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Stephanie H Swope Md | 295 Fox Drive, Boulder, CO 80303 | Physician/surgeon | 2012-10-01 ~ 2013-09-30 |
| Stephanie J Krusz | 750 Reservoir Ave, Cranston, RI 02910 | Physician/surgeon | 2007-03-29 ~ 2008-05-31 |
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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).