EMMANUEL A AGABA
Physician/surgeon


Address: 624e 220st, Bronx, NY 10467

EMMANUEL A AGABA (Credential# 900762) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2010. The license expiration date date is November 30, 2011. The license status is INACTIVE.

Business Overview

EMMANUEL A AGABA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.048527. The credential type is physician/surgeon. The effective date is December 1, 2010. The expiration date is November 30, 2011. The business address is 624e 220st, Bronx, NY 10467. The current status is inactive.

Basic Information

Licensee Name EMMANUEL A AGABA
Credential ID 900762
Credential Number 1.048527
Credential Type Physician/Surgeon
Business Address 624e 220st
Bronx
NY 10467
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2010-03-12
Effective Date 2010-12-01
Expiration Date 2011-11-30
Refresh Date 2012-03-02

Office Location

Street Address 624E 220St
City Bronx
State NY
Zip Code 10467

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Sabrina Dewar 829 East 219 Street, Bronx, NY 10467 Registered Nurse 2020-03-18 ~ 2020-07-31
Krishna Mae Frias Samson 3409 Dekalb Ave., Bronx, NY 10467 Registered Nurse 2020-02-20 ~ 2020-11-30
Augusta Osuoha 2551 Cruger Ave, Bronx, NY 10467 Pharmacist 2020-02-19 ~ 2022-01-31
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Competitor

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City Bronx
Zip Code 10467
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Bronx

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Dataset Information

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).

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