ADAM J WIESENTHAL PA (Credential# 743806) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
ADAM J WIESENTHAL PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002057. The credential type is physician assistant. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 163 Burger Rd, Rhinebeck, NY 12572-2364. The current status is active.
| Licensee Name | ADAM J WIESENTHAL PA |
| Credential ID | 743806 |
| Credential Number | 23.002057 |
| Credential Type | Physician Assistant |
| Business Address |
163 Burger Rd Rhinebeck NY 12572-2364 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2008-01-10 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-03-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1611112 | CSP.0069783 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-10-26 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 1603913 | CSP.0069624 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-10-23 | 2018-10-23 - 2019-02-28 | LAPSED |
| 499966 | CSP.0043358 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-04-15 | 2008-04-15 - 2009-02-28 | INACTIVE |
| Street Address | 163 BURGER RD |
| City | RHINEBECK |
| State | NY |
| Zip Code | 12572-2364 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Daniel Arthur Gallagher Jr | 187 East Market Street Suite 180, Rhinebeck, NY 12572 | Architect | 2020-08-01 ~ 2021-07-31 |
| Emrold Nicholas | P. O. Box 606, Rhinebeck, NY 12572 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Jennifer A Candee | 95 Camp Dr, Rhinebeck, NY 12572 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Edward B Murray | P.o. Box 672, Rhinebeck, NY 12572 | Paramedic | 2020-02-01 ~ 2021-01-31 |
| Anizka M Garcia | 591 Ackert Hook Road, Rhinebeck, NY 12572 | Engineer-in-training | 2007-11-27 ~ 2017-11-27 |
| Joseph G White | 21 Kipp Road, Rhinebeck, NY 12572 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Marjorie L Hendrickson | 25 Appletree Drive, Rhinebeck, NY 12572 | Professional Counselor | 2020-01-01 ~ 2020-12-31 |
| Sarah L Page | 81 Livingston Street, Rhinebeck, NY 12572 | Psychologist | 2020-02-01 ~ 2021-01-31 |
| Cyril Moore Construction LLC | 51 Barat Lane, Rhine Beck, NY 12572 | New Home Construction Contractor | 2019-10-01 ~ 2021-09-30 |
| Michele S Colon | 139 E. Market St, Rhinebeck, NY 12572 | Podiatrist | ~ |
| Find all Licenses in zip 12572 | |||
| City | RHINEBECK |
| Zip Code | 12572 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + RHINEBECK |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Simon Wiesenthal Center Inc | 1399 Roxbury Dr, Los Angeles, CA 90035-4709 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Adam Clements | 543 Abbey Dr, Longmont, CO 80504-2525 | Physician Assistant | ~ |
| Adam Robert Sokolowski | 35 Sylvia Ct, Plantsville, CT 06479-1322 | Physician Assistant | ~ |
| Adam R Olsen Pa | 13 Holmes Rd, Ridgefield, CT 06877-4301 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Adam R Romanek | 97 Shelley Ave, Port Chester, NY 10573 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Adam B. Shain | 1752 Nw Market St # 527, Seattle, WA 98107-5264 | Physician Assistant | 2016-08-01 ~ 2017-07-31 |
| Adam P Cadan | 2437 Bedford St Ste 1, Stamford, CT 06905-3919 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Adam C Kelly Pa | 1403 Horizon Way, Manchester, CT 06042 | Physician Assistant | 2008-03-04 ~ 2009-04-30 |
| 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 |
| Adam & Dad Inc | 114 Bayberry Dr, Thomaston, CT 06787 | Home Improvement Contractor | 2006-02-27 ~ 2006-11-30 |
Please comment or provide details below to improve the information on ADAM J WIESENTHAL PA.
| 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).