Provider Demographics
NPI:1689634826
Name:MIDDLESEX HOSPITAL
Entity Type:Organization
Organization Name:MIDDLESEX HOSPITAL
Other - Org Name:MIDDLESEX HOSP DBA COMPCARE & OCCUPATIONAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:G
Authorized Official - Last Name:CAPECE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:860-358-6110
Mailing Address - Street 1:28 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3654
Mailing Address - Country:US
Mailing Address - Phone:860-358-2765
Mailing Address - Fax:
Practice Address - Street 1:534 SAYBROOK RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4754
Practice Address - Country:US
Practice Address - Phone:860-358-2765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDDLESEX HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-23
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT=========OtherTIN #