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Organization

MIDDLESEX HOSPITAL DBA MIDDLESEX HOSPITAL PHYSICIAN SERVICES

Active
Parent organization
MIDDLESEX HOSPITAL DBA MIDDLESEX HOSPITAL PHYSICIAN SERVICES -PMA
Organization subpart
Yes

Provider details

NPI number
Legal business name
MIDDLESEX HOSPITAL DBA MIDDLESEX HOSPITAL PHYSICIAN SERVICES -PMA
Authorized official
MARISA PELLERIN (ENROLLMENT SPECIALIST)
(860) 358-4821
Entity
Organization

Contact information

Practice address
540 SAYBROOK RD STE 210, MIDDLETOWN, CT 06457-4759
(860) 358-6875
(860) 358-8693
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
03/06/2019
Last updated
03/06/2019
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