THALIA A FARAZI
Physician/surgeon


Address: 504 E 63rd St Apt 35n, New York, NY 10065-7933

THALIA A FARAZI (Credential# 564661) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 1, 2012. The license expiration date date is October 31, 2013. The license status is INACTIVE.

Business Overview

THALIA A FARAZI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.047079. The credential type is physician/surgeon. The effective date is November 1, 2012. The expiration date is October 31, 2013. The business address is 504 E 63rd St Apt 35n, New York, NY 10065-7933. The current status is inactive.

Basic Information

Licensee Name THALIA A FARAZI
Credential ID 564661
Credential Number 1.047079
Credential Type Physician/Surgeon
Business Address 504 E 63rd St Apt 35n
New York
NY 10065-7933
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2008-10-09
Effective Date 2012-11-01
Expiration Date 2013-10-31
Refresh Date 2014-02-21

Office Location

Street Address 504 E 63RD ST APT 35N
City NEW YORK
State NY
Zip Code 10065-7933

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Cevat A Ozan 26 East 64th Street, New York, NY 10065 Architect 2020-08-01 ~ 2021-07-31
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Andrew C Shih Md 200 E 62nd St Apt 9b, New York, NY 10065 Physician/surgeon 2020-07-01 ~ 2021-06-30
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Competitor

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City NEW YORK
Zip Code 10065
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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