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Organization
MIDSTATE MEDICAL CENTER
Active
Organization
MIDSTATE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD BOISVERT (VP CFO)
(860) 545-0585
Entity
Organization
Contact information
Practice address
435 LEWIS AVENUE, MERIDEN, CT 06451-2101
(203) 694-8200
(860) 696-6035
Mailing address
P.O. BOX 4131, YALESVILLE, CT 06492-1481
(203) 284-1340
(203) 265-4557
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
—
NULL
282N00000X
General Acute Care Hospital
0070
CT
282N00000X
General Acute Care Hospital
Primary
—
NULL
363LN0000X
Neonatal Nurse Practitioner
—
NULL
363LN0000X
Neonatal Nurse Practitioner
—
—
Other
Enumeration date
05/10/2006
Last updated
11/27/2023
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