NAZANIN BARZIDEH MD
Physician/surgeon


Address: North Shore Retina Physician, Pllc, East Hills, NY 11576

NAZANIN BARZIDEH MD (Credential# 562750) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2010. The license expiration date date is April 30, 2011. The license status is INACTIVE.

Business Overview

NAZANIN BARZIDEH MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.045168. The credential type is physician/surgeon. The effective date is May 1, 2010. The expiration date is April 30, 2011. The business address is North Shore Retina Physician, Pllc, East Hills, NY 11576. The current status is inactive.

Basic Information

Licensee Name NAZANIN BARZIDEH MD
Credential ID 562750
Credential Number 1.045168
Credential Type Physician/Surgeon
Business Address North Shore Retina Physician, Pllc
East Hills
NY 11576
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2007-03-01
Effective Date 2010-05-01
Expiration Date 2011-04-30
Refresh Date 2011-08-02

Other licenses

ID Credential Code Credential Type Issue Term Status
470182 CSP.0041465 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2007-05-09 2009-03-01 - 2011-02-28 INACTIVE

Office Location

Street Address North Shore Retina Physician, PLLC
City East Hills
State NY
Zip Code 11576

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Chris M Sideris 365 Chestnut Dr, East Hills, NY 11576 Professional Engineer 2020-02-01 ~ 2021-01-31
Richard Carlin 1 The Maples, Roslyn, NY 11576 Notary Public Appointment 2006-01-01 ~ 2010-12-31
Daniela Barisano 36 Flamigo Rd N, Roslyn, NY 11576 Pharmacy Intern 2019-09-16 ~ 2023-09-30
Kenneth W Siegel 204 Augusta Ct., Roslyn, NY 11576 Architect 2019-08-01 ~ 2020-07-31
Igor Elman 100 Port Washington Blvd, Roslyn, NY 11576 Controlled Substance Registration for Practitioner 2017-05-20 ~ 2019-02-28
Arthur Aylaroff 63-60 98th St #f15, Rego Park, NY 11576 Pharmacy Technician 2006-05-03 ~ 2007-03-31
Jonathan M Teichberg 145 Dogwood Rd, Roslyn, NY 11576 Registered Nurse - Temporary 2015-11-04 ~ 2016-03-02
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City East Hills
Zip Code 11576
License Type Physician/Surgeon
License Type + County Physician/Surgeon + East Hills

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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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