Provider Demographics
NPI:1982407094
Name:MIDDLESEX HOSPITAL
Entity type:Organization
Organization Name:MIDDLESEX HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO V.P.
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-358-3005
Mailing Address - Street 1:536 SAYBROOK RD LOWER LEVEL
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4783
Mailing Address - Country:US
Mailing Address - Phone:860-358-2040
Mailing Address - Fax:860-358-2041
Practice Address - Street 1:536 SAYBROOK RD LOWER LEVEL
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4783
Practice Address - Country:US
Practice Address - Phone:860-358-2040
Practice Address - Fax:860-358-2041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy