SUPRIYA JAMBHEKAR
Physician/surgeon


Address: 2116 Menahan Street, Ridgewood, NY 11385

SUPRIYA JAMBHEKAR (Credential# 559798) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 2, 2004. The license expiration date date is August 31, 2005. The license status is INACTIVE.

Business Overview

SUPRIYA JAMBHEKAR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.042216. The credential type is physician/surgeon. The effective date is August 2, 2004. The expiration date is August 31, 2005. The business address is 2116 Menahan Street, Ridgewood, NY 11385. The current status is inactive.

Basic Information

Licensee Name SUPRIYA JAMBHEKAR
Credential ID 559798
Credential Number 1.042216
Credential Type Physician/Surgeon
Business Address 2116 Menahan Street
Ridgewood
NY 11385
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2004-03-15
Effective Date 2004-08-02
Expiration Date 2005-08-31
Refresh Date 2009-07-08

Office Location

Street Address 2116 Menahan Street
City Ridgewood
State NY
Zip Code 11385

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City Ridgewood
Zip Code 11385
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Ridgewood

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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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