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General NPI Number Information
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NPI Number | 1023305455
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Entity Type | Organization
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Legal Business Name | MIDDLESEX HOSP DBA THORACIC SURG/OBGYN ONOCOLOGY
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 10/25/2013
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Provider Practice Location Address
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Address Line | 540 SAYBROOK RD STE 180
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City | MIDDLETOWN
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State | CT
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Zip | 06457-4759
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Country | US
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Telephone | 860-358-2780
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Fax | 860-358-2781
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Provider Business Mailing Address
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Address Line | 28 CRESCENT ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-3654
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Country | US
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Telephone | 860-358-2780
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Fax | 860-358-2781
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | VINCENT G CAPECE JR.
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Credential |
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Telephone | 860-358-6110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 23646
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 44328
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 48090
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 33511
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License Number State | CT
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