Provider Demographics
NPI:1982652343
Name:MIDDLESEX HOSPITAL
Entity Type:Organization
Organization Name:MIDDLESEX HOSPITAL
Other - Org Name:MIDDLESEX HOSPITAL PSYCH
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO EFF 9/1/2010
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPECE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:860-358-6140
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:860-358-6394
Mailing Address - Fax:860-358-6748
Practice Address - Street 1:28 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3654
Practice Address - Country:US
Practice Address - Phone:860-358-6394
Practice Address - Fax:860-358-6748
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDDLESEX HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-05
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT07S020273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT07S020Medicare Oscar/Certification