NICOLE N LAY (Credential# 742382) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
NICOLE N LAY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.000633. The credential type is physician assistant. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 305 Black Rock Turnpike, Fairfield, CT 06825. The current status is active.
| Licensee Name | NICOLE N LAY |
| Credential ID | 742382 |
| Credential Number | 23.000633 |
| Credential Type | Physician Assistant |
| Business Address |
305 Black Rock Turnpike Fairfield CT 06825 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1997-01-24 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-04-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 46228 | CSP.0025180 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-06-18 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 305 Black Rock Turnpike |
| City | FAIRFIELD |
| State | CT |
| Zip Code | 06825 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert A Stanton | 305 Black Rock Turnpike, Fairfield, CT 06825 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Patrick W Kwok Md | 305 Black Rock Turnpike, Fairfield, CT 06825 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Perry A Shear | 305 Black Rock Turnpike, Fairfield, CT 06825 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Joel Malin Md | 305 Black Rock Turnpike, Fairfield, CT 06825 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Romulo V Vasquez | 305 Black Rock Turnpike, Fairfield, CT 06825 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Daniel E Weiland | 305 Black Rock Turnpike, Fairfield, CT 06825 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| James J Fitzgibbons Md | 305 Black Rock Turnpike, Fairfield, CT 06825-5340 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Fairfield Surgery Center | 305 Black Rock Turnpike, Fairfield, CT 06825 | Out-patient Surgical Facility | 2018-10-01 ~ 2020-09-30 |
| Joel W Malin | 305 Black Rock Turnpike, Fairfield, CT 06825 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alexander M Testani | 77 Winoca Rd, Fairfield, CT 06825 | Emergency Medical Technician | 2020-06-26 ~ 2022-03-31 |
| Salome Cleopatra Nail | 2399 Black Rock Turnpike, Fairfield, CT 06825 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Angela M Carmona | 198 Castle Ave, Fairfield, CT 06825 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Maria D Coutinho | 131 Roseville Street, Fairfield, CT 06825 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Jie Che | 1519 Black Rock Tpke, Fairfield, CT 06825 | Esthetician | ~ |
| Eva I Chiamulera | 86 Brookfield Avenue, Fairfield, CT 06825 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Suzanne P Taluy | 558 Villa Ave, Fairfield, CT 06825 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Benjamin Allan Gott | 262 Euclid Avenue, Fairfield, CT 06825 | Notary Public Appointment | 2020-06-01 ~ 2025-05-31 |
| Charles J Applebaum | 841 Stratfield Rd, Fairfield, CT 06825 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Jeri Kriskey | 1179 Merritt Street, Fairfield, CT 06825 | Marital and Family Therapist Associate | 2020-06-24 ~ 2022-06-24 |
| Find all Licenses in zip 06825 | |||
| City | FAIRFIELD |
| Zip Code | 06825 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + FAIRFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nicole R Ciccia | 71 Joy Rd Apt C, Milford, CT 06460-6052 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Courtney Nicole Enos | 916 1/2 4th St Ne, Byron, MN 55920-1530 | Physician Assistant | ~ |
| Nicole D Greco Pa | 604 Tompkins Ave Apt B5, Mamaroneck, NY 10543-3729 | Physician Assistant | 2015-03-01 ~ 2016-02-29 |
| Nicole Ferrantelli | 59 Old Post Rd Apt F7, Clinton, CT 06413-1864 | Physician Assistant | 2010-07-01 ~ 2011-06-30 |
| Jaime A Camacho | 6 Nicole Ln, Burlington, CT 06013-2123 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Ashley Nicole Hiep | 3 Sgt. Demeola Rd., Blauvelt, NY 10913 | Physician Assistant | ~ |
| Nicole M Esposito | 5 Lexington Ct, Shelton, CT 06484-5961 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Nicole Ann Dietzel | 94 Hawthorne Dr, Southington, CT 06489-2818 | Physician Assistant | 2020-09-01 ~ 2021-08-31 |
| Nicole M Spataro | 427 Williams Rd, Wallingford, CT 06492-2690 | Physician Assistant | 2018-11-01 ~ 2019-10-31 |
| Nicole S Feagin | 30 Shelburne Rd, Stamford, CT 06902-3628 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
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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).