KAKRA S GYAMBIBI MD (Credential# 995919) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2019. The license expiration date date is July 31, 2020. The license status is ACTIVE.
KAKRA S GYAMBIBI MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.050062. The credential type is physician/surgeon. The effective date is August 1, 2019. The expiration date is July 31, 2020. The business address is 25 Taylor St Apt 11, Stamford, CT 06902-5758. The current status is active.
| Licensee Name | KAKRA S GYAMBIBI MD |
| Credential ID | 995919 |
| Credential Number | 1.050062 |
| Credential Type | Physician/Surgeon |
| Business Address |
25 Taylor St Apt 11 Stamford CT 06902-5758 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - ON PROBATION |
| Active | 1 |
| Issue Date | 2011-07-01 |
| Effective Date | 2019-08-01 |
| Expiration Date | 2020-07-31 |
| Refresh Date | 2020-04-22 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 995757 | CSP.0050060 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2011-07-11 | 2017-03-01 - 2019-02-28 | LAPSED |
| Street Address | 25 TAYLOR ST APT 11 |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902-5758 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ruth Boadu | 25 Taylor St Apt 11, Stamford, CT 06902-5758 | Controlled Substance Registration for Practitioner | 2015-08-26 ~ 2017-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeris Maydeli Flores | 153 Fairfield Av, Stamford, CT 06902 | Nail Technician | ~ |
| Reynaldo De La Cruz | 64 Brookside Drive, Stamford, CT 06902 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Darren J Petillo | 5 Hundley Court, Stamford, CT 06902 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Antonios Restaurant | 405 West Main St, Stamford, CT 06902 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Edward Smith | 184 Fairfield Ave., Stamford, CT 06902 | Home Improvement Contractor | ~ |
| Margaret A Dorrance | 24c Hamilton Court, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carolyn Maguire | 48 Nelson St, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Evelyne Joassin | 17 George St., Stamford, CT 06902 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Andrea Bynoe | 34 Melrose Pl, Stamford, CT 06902 | Notary Public Appointment | 1994-04-06 ~ 1999-04-30 |
| Ravi K Ahuja | 296 Westover Rd, Stamford, CT 06902 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06902 | |||
| City | STAMFORD |
| Zip Code | 06902 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + STAMFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Arnold R Kriegstein | College Physician, New York, NY 10032 | Physician/surgeon | 1993-04-23 ~ 1994-03-31 |
| Brent Robert Jacobson | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Catherine Nguyen Keegan | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Nazanin Barzideh Md | North Shore Retina Physician, Pllc, East Hills, NY 11576 | Physician/surgeon | 2010-05-01 ~ 2011-04-30 |
| Barbara M Galko Md | Danbury Office of Physician Services PC, Danbury, CT 06810 | Physician/surgeon | 2010-06-01 ~ 2011-05-31 |
| Susan J Batlan Md | Eye Physician Associates of Hartford, West Hartford, CT 06107 | Physician/surgeon | 2000-07-27 ~ 2001-07-31 |
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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).