Provider Demographics
NPI:1760454334
Name:MIDDLESEX HOSPITAL
Entity type:Organization
Organization Name:MIDDLESEX HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
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:860-358-4821
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:860-358-4821
Mailing Address - Fax:860-358-6094
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?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT261QE0002X, 282N00000X
273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT012OtherBLUE CROSS
CT4025102/4041810Medicaid
CT070020/07S020Medicare ID - Type Unspecified