Organization
MIDDLESEX HOSPITAL
Active
Parent organization
MIDDLESEX HOSPITAL
Other names
Middlesex Hospital dba Middlesex Hospital Psychiatric Physician Servic
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIDDLESEX HOSPITAL
Authorized official
VINCENT G. CAPECE JR. (CEO)
(860) 358-6394
Entity
Organization
Contact information
Practice address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6394
(860) 358-6748
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6394
(860) 358-6748
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
C03568
CT
2084P0800X
Psychiatry Physician
Primary
—
CT
363L00000X
Nurse Practitioner
C03568
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
C03568
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK1085
RR MEDICARE
CT
Enumeration date
03/17/2006
Last updated
12/19/2022
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