ELENA NOVAKOVA PA (Credential# 743046) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
ELENA NOVAKOVA PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001297. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 16 Glen Drive, South Salem, NY 10590. The current status is active.
Licensee Name | ELENA NOVAKOVA PA |
Credential ID | 743046 |
Credential Number | 23.001297 |
Credential Type | Physician Assistant |
Business Address |
16 Glen Drive South Salem NY 10590 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2002-11-22 |
Effective Date | 2020-06-01 |
Expiration Date | 2021-05-31 |
Refresh Date | 2020-03-02 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
325522 | CSP.0033051 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2002-12-17 | 2019-03-01 - 2021-02-28 | ACTIVE |
Street Address | 16 GLEN DRIVE |
City | SOUTH SALEM |
State | NY |
Zip Code | 10590 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Leonid Bilenkin | 16 Glen Drive, South Salem, NY 10590 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Alice B Gottlieb | 51 Twin Lakes Rd, South Salem, NY 10590 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
Lorraine M Gengo | 65 Grandview Road, South Salem, NY 10590 | Massage Therapist | 2020-06-01 ~ 2022-05-31 |
Jon C Jensen | 11 Elmwood Rd, South Salem, NY 10590 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Ann Marie Sementilli | 14 East Street, South Salem, NY 10590 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Louis M Galasso | 162 Journeys End Rd, South Salem, NY 10590 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
Bozena Piechota | 4 Rainbow Hill Road, South Salem, NY 10590 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Jane H Wakeman | 457 Smith Ridge Rd., South Salem, NY 10590 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Mark A Caviola | 14 North Lake Circle, South Salem, NY 10590 | Sub-surface Sewage Installer | 2020-08-01 ~ 2021-07-31 |
Ann M Nolan | 171journey's End Road, South Salem, NY 10590 | Physical Therapist | 2020-07-01 ~ 2021-06-30 |
Denise T Mackin | 2 Country Lane, South Salem, NY 10590 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
Find all Licenses in zip 10590 |
City | SOUTH SALEM |
Zip Code | 10590 |
License Type | Physician Assistant |
License Type + County | Physician Assistant + SOUTH SALEM |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Hubert G Robin | 32 Elena Drive, Cortlandt Manor, NY 10567 | Physician Assistant | 2014-03-01 ~ 2015-02-28 |
Elena Nicola | 8685 Rio San Diego Dr Apt 4415, San Diego, CA 92108-6561 | Physician Assistant | 2010-11-01 ~ 2011-10-31 |
David Ofori | 11 Elena Drive, Cortlandt Manor, NY 10567 | Physical Therapist Assistant | ~ |
Elena R Tedeschi | 59 Alfred Drive, Colchester, CT 06415 | Occupational Therapist Assistant | 2019-08-01 ~ 2021-07-31 |
Elena E Patsera | 7h Mansion Woods Dr, Agawam, MA 01001-2392 | Physical Therapist Assistant | 2020-05-01 ~ 2021-04-30 |
Elena J Grimes | 157 Fountain Street # E3, New Haven, CT 06515 | Family Child Care Assistant | 2011-01-07 ~ 2013-01-31 |
Elena Seberina Estevez | 73 Coalpit Hill Rd #4, Danbury, CT 06810 | Family Child Care Assistant | 2020-05-11 ~ 2022-05-31 |
Elena Elena | 114 Hemlock Dr, Southington, CT 06489-3916 | Massage Therapist | 2019-11-01 ~ 2021-10-31 |
Physician Assistant Foundation of The American Academy of Physician Assistants | 2318 Mill Rd Ste 1300, Alexandria, VA 22314-6868 | Public Charity | 2019-12-01 ~ 2020-11-30 |
Elena Fomchenko | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
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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).