MICHELLE NISENBAUM MD (Credential# 560991) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
MICHELLE NISENBAUM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.043409. The credential type is physician/surgeon. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 7 Brandywine Lane, Sandy Hook, CT 06482. The current status is active.
| Licensee Name | MICHELLE NISENBAUM MD |
| Credential ID | 560991 |
| Credential Number | 1.043409 |
| Credential Type | Physician/Surgeon |
| Business Address |
7 Brandywine Lane Sandy Hook CT 06482 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2005-05-10 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-12-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 406255 | CSP.0037549 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-06-06 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 7 Brandywine Lane |
| City | Sandy Hook |
| State | CT |
| Zip Code | 06482 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Catherine A D'aquila | 4 Fleetwood Drive, Sandy Hook, CT 06482 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Deanna M Galanis | 9 Riverside Road, Sandy Hook, CT 06482 | Eyelash Technician | 2020-06-26 ~ 2022-02-28 |
| Bruce J Kerns | 42 Great Quarter Rd, Sandy Hook, CT 06482 | Veterinarian | 2020-06-01 ~ 2021-05-31 |
| Nancy B Sheehan | 6 Clearview Drive, Sandy Hook, CT 06482 | Notary Public Appointment | 2020-06-01 ~ 2025-05-31 |
| Elisa A Keenan | 8 Farview Dr, Sandy Hook, CT 06482 | Licensed Practical Nurse | 2020-04-01 ~ 2021-03-31 |
| Children's Adventure Center Inc. | 14 Riverside Road, Sandy Hook, CT 06482 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Linda J Wallace | 80 Walnut Tree Hill, Sandy Hook, CT 06482 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Gina E Long | 35 Poplar Drive, Sandy Hook, CT 06482 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Phillip M Lombardo | 42 Berkshire Road, Sandy Hook, CT 06482 | Real Estate Salesperson | 2020-06-15 ~ 2021-05-31 |
| Robert D Mitchell | 71 Osborn Hill Rd, Sandy Hook, CT 06482 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06482 | |||
| City | Sandy Hook |
| Zip Code | 06482 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Sandy Hook |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michelle Udeshi Md | 105 Via Foresta Ln, Williamsville, NY 14221 | Physician/surgeon | 2019-02-01 ~ 2020-01-31 |
| Michelle Garcia-rybkin | 70 Dubois St, Newburgh, NY 12550-4851 | Physician/surgeon | ~ |
| Michelle C Mcdade Md | 10 Newcastle Pl, Unionville, CT 06085 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Michelle A Hayes | P.o. Box 99, Owings Mills, MD 21117 | Physician/surgeon | 2002-11-05 ~ 2003-11-30 |
| Michelle L Kayser | 3016 N Harrison St, Wilmington, DE 19802-2936 | Physician/surgeon | ~ |
| Michelle Loy | 32 Strawberry Hill Ct, Stamford, CT 06902-2594 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Michelle Leon Md | 166 Deer Run, Burlington, CT 06013 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Michelle Brosnan | 1345 Rxr Plz, Uniondale, NY 11556-1301 | Physician/surgeon | 2019-05-01 ~ 2020-04-30 |
| Michelle P Mallitz Md | 76 Lords Hwy, Weston, CT 06883-1728 | Physician/surgeon | 2012-07-01 ~ 2013-06-30 |
| Michelle W Diu Md | 10130 Sw Morrison St, Portland, OR 97225 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
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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).