BRENT M REILLY PA-C (Credential# 743573) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is February 1, 2020. The license expiration date date is January 31, 2021. The license status is ACTIVE.
BRENT M REILLY PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001824. The credential type is physician assistant. The effective date is February 1, 2020. The expiration date is January 31, 2021. The business address is 1796 Stone Ave, East Meadow, NY 11554-1007. The current status is active.
| Licensee Name | BRENT M REILLY PA-C |
| Credential ID | 743573 |
| Credential Number | 23.001824 |
| Credential Type | Physician Assistant |
| Business Address |
1796 Stone Ave East Meadow NY 11554-1007 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2006-09-27 |
| Effective Date | 2020-02-01 |
| Expiration Date | 2021-01-31 |
| Refresh Date | 2020-01-21 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 453345 | CSP.0040777 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-10-13 | 2015-03-01 - 2017-02-28 | INACTIVE |
| 843891 | 70.004158 | Emergency Medical Technician | 2003-10-06 | 2003-10-06 - 2005-03-31 | INACTIVE |
| Street Address | 1796 STONE AVE |
| City | EAST MEADOW |
| State | NY |
| Zip Code | 11554-1007 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jingjing Wu | 209 Vincent Dr, East Meadow, NY 11554 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Michael Carey Lefkowitz | 1451 Dieman Lane, East Meadow, NY 11554 | Tax Preparer/facilitator Permit | 2020-02-11 ~ 2022-02-28 |
| Alex K Lukose | 247 Wickshire Drive, East Meadow, NY 11554 | Tax Preparer/facilitator Permit | 2020-02-11 ~ 2022-02-28 |
| Hemang Shah | 270-01 Hillside Ave, New Hyde Park, NY 11554 | Tax Preparer/facilitator Permit | 2020-02-11 ~ 2022-02-28 |
| Lenina Thumma | 141 Melanie Dr, East Meadow, NY 11554 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Shantell Ingram-green | 758 Merrick Ave, East Meadow, NY 11554 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Marios C Tinis | 378 Star St, E Meadow, NY 11554 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Cini Jacob | 920 Maple Lane, East Meadow, NY 11554 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Pamela K Horvath | 2362 Sixth Street, East Meadow, NY 11554 | Notary Public Appointment | 2013-12-01 ~ 2018-11-30 |
| Matthew G Melnick | 889 Blendwood Drive, East Meadow, NY 11554 | Notary Public Appointment | 2015-12-11 ~ 2020-12-31 |
| Find all Licenses in zip 11554 | |||
| City | EAST MEADOW |
| Zip Code | 11554 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + EAST MEADOW |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brent Pleimann Pa | 89 Masters Ln, Milford, CT 06461-1690 | Physician Assistant | 2017-10-01 ~ 2018-09-30 |
| Brent A Albright | 41 Tuttle Rd, Middletown, CT 06457-1827 | Physician Assistant | 2012-09-01 ~ 2013-08-31 |
| Brent Michael Selders | 5717 Pacific Center Blvd, San Diego, CA 92121 | Physician Assistant | 2019-11-01 ~ 2020-10-31 |
| Dawn Marie O'reilly Pa | 67 Wanda Lane, Middletown, CT 06457-8717 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Laura Reilly Sievering Pa-c | 25 Somers Hill Circle, Somers, CT 06071 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| O'reilly & Son LLC | 9 Greenmeadow Rd, Pawcatuck, CT 06379-2001 | Home Improvement Contractor | 2012-12-01 ~ 2013-11-30 |
| Brent Robert Jacobson | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Joshua Pescosolido | 96 Brent Drive, Vernon, CT 06066 | Family Child Care Assistant | 2005-07-07 ~ 2007-07-31 |
| Henry O'reilly · O'reilly & Sons | 9 Greenmeadow Rd, Pawcatuck, CT 06379-2001 | Home Improvement Contractor | ~ |
| James B Reilly · J Reilly Painting & Wallcovering | 18 Overlook Rd, Gales Ferry, CT 06335 | Home Improvement Contractor | 2002-12-01 ~ 2003-11-30 |
Please comment or provide details below to improve the information on BRENT M REILLY PA-C.
| 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).