EUNJIN PARK (Credential# 743820) 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.
EUNJIN PARK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.002071. The credential type is physician assistant. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 5 Perryridge Road, Greenwich, CT 06831. The current status is active.
| Licensee Name | EUNJIN PARK |
| Credential ID | 743820 |
| Credential Number | 23.002071 |
| Credential Type | Physician Assistant |
| Business Address |
5 Perryridge Road Greenwich CT 06831 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2008-01-22 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-05-21 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 501125 | CSP.0043409 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-05-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 5 perryridge road |
| City | Greenwich |
| State | CT |
| Zip Code | 06831 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Deepa Jansen | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Ginamarie Papia | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Ju Young Bae | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Michael Foti | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Waqas Salam | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Romelle J Maloney | 5 Perryridge Road, Greenwich, CT 06830 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kristin T Hsieh | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2020-06-22 ~ 2021-06-28 |
| Fatema S Esaa | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2020-06-22 ~ 2021-06-28 |
| Jeremy B Barowsky | 5 Perryridge Road, Greenwich, CT 06830 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jan Zislis Md | 5 Perryridge Road, Greenwich, CT 06830 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Hui Ja Paek | 235 Glenville Rd, Greenwich, CT 06831 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Gloria E Triana | 11 Hollow Wood Lane, Greenwich, CT 06831 | Real Estate Salesperson | ~ |
| Pointe Residential Builders LLC | 881 Lake Ave, Greenwich, CT 06831 | Major Contractor | 2020-06-26 ~ 2021-06-30 |
| Hrishikesh N. Gogate Dds | 90 Dearfield Drive, Greenwich, CT 06831 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Deborah Alza | 10 Buena Vista Drive, Greenwich, CT 06831 | Notary Public Appointment | 2020-05-01 ~ 2025-04-30 |
| Hy Pomerance | 55a Byram Terrace Drive, Greenwich, CT 06831 | Psychologist | 2020-09-01 ~ 2021-08-31 |
| Maryann Margolies | 8 Pilgrim Dr, Greenwich, CT 06831 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Karen L Kain | 129 Cutler Rd, Greenwich, CT 06831 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Joel M Rein | 2 1/2 Dearfield Dr, Greenwich, CT 06831 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Young Sook Lieu | 52 Almira Dr Unit C, Greenwich, CT 06831 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Find all Licenses in zip 06831 | |||
| City | Greenwich |
| Zip Code | 06831 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Greenwich |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eunjin Koo | 4661 189th St, Flushing, NY 11358 | Massage Therapist | 2020-01-01 ~ 2021-12-31 |
| Sarah Elizabeth Hill | 211 Park Rd, Oxford, CT 06478-6127 | Physician Assistant | ~ |
| Janis A Jaquez | 74 Park Rd, West Hartford, CT 06119-1853 | Physician Assistant | 2019-12-01 ~ 2020-11-30 |
| Chihiro Shinohara | 4 Westchester Park Dr Fl 4, White Plains, NY 10604-3434 | Physician Assistant | ~ |
| Alicia K Beardsley | 6 Douglass Road, Hyde Park, NY 12538 | Physician Assistant | ~ |
| George A Lopez Pa | 1759 W End Ave, New Hyde Park, NY 11040-4024 | Physician Assistant | 2019-12-01 ~ 2020-11-30 |
| Joseph R Varano | 2 Park Place, Hartford, CT 06106 | Physician Assistant | 2013-08-01 ~ 2014-07-31 |
| Vaishali T Sheth Pa | 139 Park Ave Apt. 2nd Floor, Naugatuck, CT 06770 | Physician Assistant | 2006-11-06 ~ 2007-11-30 |
| Shinu Kuriakose | 54 Edgewood Dr, New Hyde Park, NY 11040-3738 | Physician Assistant | 2019-08-01 ~ 2020-07-31 |
| Samuel Shajnfeld | 66-10 Booth St, Rego Park, NY 11374-4634 | Physician Assistant | 2012-11-01 ~ 2013-10-31 |
Please comment or provide details below to improve the information on EUNJIN PARK.
| 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).