Provider Demographics
NPI:1194781328
Name:MIDDLESEX HOSPITAL
Entity type:Organization
Organization Name:MIDDLESEX HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VINNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPECE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-358-6110
Mailing Address - Street 1:770 SAYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4739
Mailing Address - Country:US
Mailing Address - Phone:860-358-5600
Mailing Address - Fax:
Practice Address - Street 1:117 MAIN STREET EXT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3849
Practice Address - Country:US
Practice Address - Phone:860-358-5600
Practice Address - Fax:860-358-5723
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDDLESEX HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-25
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT07-7086A251E00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004074373OtherAGENCY/AGING SOUTHCENTRAL
CT004074373OtherAGENCY/AGING SOUTHCENTRAL