JESSICA J KANDEL
Physician/surgeon


Address: 3959 Broadway, Bhn 214, New York, NY 10032

JESSICA J KANDEL (Credential# 560516) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2013. The license expiration date date is June 30, 2014. The license status is INACTIVE.

Business Overview

JESSICA J KANDEL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.042934. The credential type is physician/surgeon. The effective date is July 1, 2013. The expiration date is June 30, 2014. The business address is 3959 Broadway, Bhn 214, New York, NY 10032. The current status is inactive.

Basic Information

Licensee Name JESSICA J KANDEL
Credential ID 560516
Credential Number 1.042934
Credential Type Physician/Surgeon
Business Address 3959 Broadway, Bhn 214
New York
NY 10032
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2004-11-15
Effective Date 2013-07-01
Expiration Date 2014-06-30
Refresh Date 2014-10-03

Other licenses

ID Credential Code Credential Type Issue Term Status
388497 CSP.0036698 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2004-11-23 2006-03-01 - 2007-02-28 INACTIVE

Office Location

Street Address 3959 Broadway, BHN 214
City New York
State NY
Zip Code 10032

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City New York
Zip Code 10032
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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