KIM THU C PHAM MD (Credential# 558850) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
KIM THU C PHAM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.041267. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 104 Genesee Lane, Madison, CT 06443. The current status is active.
| Licensee Name | KIM THU C PHAM MD |
| Credential ID | 558850 |
| Credential Number | 1.041267 |
| Credential Type | Physician/Surgeon |
| Business Address |
104 Genesee Lane Madison CT 06443 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2003-03-26 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-01-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 463478 | CSP.0041152 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-02-16 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 104 GENESEE LANE |
| City | MADISON |
| State | CT |
| Zip Code | 06443 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Caitlyn Beverly Darosa | Lyle Dr, Madison, CT 06443 | Registered Nurse | ~ |
| Roberts Food Center · Rjf Inc Dba | 514 Old Toll Rd, Madison, CT 06443 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Karen D Leonetti · Rapuano | 553 Green Hill Rd, Madison, CT 06443 | Radiographer | 2020-09-01 ~ 2021-08-31 |
| Pasquale Sabatasso | 122 River Edge Farms Road, Madison, CT 06443 | Barber | 2020-07-01 ~ 2022-06-30 |
| Madision Health Foods · Jum Ok Coker | 59 Wall St, Madison, CT 06443 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Madison Community Services Inc. | P.o. Box 148, Madison, CT 06443 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Shaina Michele Levinson | 52 East Wharf Rd, Madison, CT 06443 | Master's Level Social Worker | ~ |
| Stephen G Lynch · Lynch, Stephen Gerard | 12 Milestone Lane, Madison, CT 06443 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| David F Courtney Md | 38 Old Duck Hole Road, Madison, CT 06443 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Sydni E Marmor | 560 Opening Hill Road, Madison, CT 06443 | Professional Counselor | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06443 | |||
| City | MADISON |
| Zip Code | 06443 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + MADISON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Victoria I. Pham | 59 Hastings Ln, Stamford, CT 06905-2902 | Physician/surgeon | ~ |
| Thao N Pham | 312 Garibaldi Ave, Stratford, CT 06497 | Physician/surgeon | ~ 1999-03-31 |
| Peter A Pham | One River Place, Apt. 702, New York, NY 10036 | Physician/surgeon | 2002-11-07 ~ 2003-11-30 |
| Victoria Pham | 59 Hastings Lane, Stamford, CT 06905 | Physician/surgeon | 2019-07-01 ~ 2020-06-30 |
| Laura T Pham | 22 Woodbine Road, Woodbridge, CT 06525 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Justin Pham | 10 Torrey Pines Ln, Newport Beach, CA 92660-5139 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Charlotte Uyen Pham | 1501 White Pine Dr, Durham, NC 27705-7521 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Stephanie Jamie Pham | 245 5th Ave Floor 3, New York, NY 10016 | Physician Assistant | ~ |
| Caroline Pham | 5 Perryridge Rd, Greenwich, CT 06830-4608 | Resident Physician | 2020-06-22 ~ 2023-06-26 |
| Vi Hoang Pham | 386 Island Pond Rd, Springfield, MA 01118-1001 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
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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).