SAMAR HAZZAN
Physician/surgeon


Address: 392 Cpw #15t, New York, NY 10025

SAMAR HAZZAN (Credential# 556204) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 2, 2000. The license expiration date date is May 31, 2001. The license status is INACTIVE.

Business Overview

SAMAR HAZZAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.038616. The credential type is physician/surgeon. The effective date is May 2, 2000. The expiration date is May 31, 2001. The business address is 392 Cpw #15t, New York, NY 10025. The current status is inactive.

Basic Information

Licensee Name SAMAR HAZZAN
Credential ID 556204
Credential Number 1.038616
Credential Type Physician/Surgeon
Business Address 392 Cpw #15t
New York
NY 10025
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2000-05-02
Effective Date 2000-05-02
Expiration Date 2001-05-31
Refresh Date 2009-07-08

Office Location

Street Address 392 CPW #15T
City New York
State NY
Zip Code 10025

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Pamela Godwin 245 West 107th Street, New York, NY 10025 Registered Nurse 2020-07-01 ~ 2021-06-30
Tara A. Smith 54 West 106 Street Apt 1a, New York, NY 10025 Registered Nurse 2019-12-01 ~ 2020-11-30
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Competitor

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City New York
Zip Code 10025
License Type Physician/Surgeon
License Type + County Physician/Surgeon + New York

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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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