NIDHI AGRAWAL MD
Physician/surgeon


Address: Generations Family Health Ctr, Willimantic, CT 06226

NIDHI AGRAWAL MD (Credential# 557808) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 13, 2004. The license expiration date date is August 31, 2005. The license status is INACTIVE.

Business Overview

NIDHI AGRAWAL MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040225. The credential type is physician/surgeon. The effective date is August 13, 2004. The expiration date is August 31, 2005. The business address is Generations Family Health Ctr, Willimantic, CT 06226. The current status is inactive.

Basic Information

Licensee Name NIDHI AGRAWAL MD
Credential ID 557808
Credential Number 1.040225
Credential Type Physician/Surgeon
Business Address Generations Family Health Ctr
Willimantic
CT 06226
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2002-03-07
Effective Date 2004-08-13
Expiration Date 2005-08-31
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
311158 CSP.0032235 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2004-02-29 - 2005-02-28 INACTIVE

Office Location

Street Address GENERATIONS FAMILY HEALTH CTR
City WILLIMANTIC
State CT
Zip Code 06226

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Elizabeth A Bailey 152 Main St, Willimantic, CT 06226 Licensed Practical Nurse 2020-07-01 ~ 2021-06-30
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Competitor

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City WILLIMANTIC
Zip Code 06226
License Type Physician/Surgeon
License Type + County Physician/Surgeon + WILLIMANTIC

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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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