VIJAYATHA C GUNDARAPU
Physician/surgeon


Address: 78-40, 164th Street, Fresh Meadows, NY 11366

VIJAYATHA C GUNDARAPU (Credential# 563937) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2008. The license expiration date date is April 30, 2009. The license status is INACTIVE.

Business Overview

VIJAYATHA C GUNDARAPU is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.046355. The credential type is physician/surgeon. The effective date is April 1, 2008. The expiration date is April 30, 2009. The business address is 78-40, 164th Street, Fresh Meadows, NY 11366. The current status is inactive.

Basic Information

Licensee Name VIJAYATHA C GUNDARAPU
Credential ID 563937
Credential Number 1.046355
Credential Type Physician/Surgeon
Business Address 78-40, 164th Street
Fresh Meadows
NY 11366
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2008-04-01
Effective Date 2008-04-01
Expiration Date 2009-04-30
Refresh Date 2009-08-13

Office Location

Street Address 78-40, 164th Street
City Fresh Meadows
State NY
Zip Code 11366

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Joseph Q Do 160-22 77th Road, Fresh Meadows, NY 11366 Pharmacist 2020-02-01 ~ 2022-01-31
Robert A Klaus 73-52 193 Street, Flushing, NY 11366 Pharmacist 2020-02-01 ~ 2022-01-31
Shaohui Mao 164-23 77th Road, Fresh Meadows, NY 11366 Professional Engineer 2020-02-01 ~ 2021-01-31
Susan M Levine 164-34 73rd Ave., Fresh Meadows, NY 11366 Dentist 2019-06-01 ~ 2020-05-31
Maryam Hamidieh Firoozan 73-21 197 Street, Flushing, NY 11366 Professional Engineer ~
Insoo Kim 75-22 Parsons Blvd., Apt. E2, Flushing, NY 11366 Asbestos Abatement Supervisor 2018-02-01 ~ 2019-01-31
Robin J Hur 188-01 Union Turnpike, Fresh Meadows, NY 11366 Controlled Substance Registration for Practitioner 2017-03-01 ~ 2019-02-28
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Competitor

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City Fresh Meadows
Zip Code 11366
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Fresh Meadows

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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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