{
"Npi": {
"NPI": "1689634826",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "MIDDLESEX HOSPITAL",
"ParentOrgTIN": null,
"OrgName": "MIDDLESEX HOSPITAL",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "28 CRESCENT ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIDDLETOWN",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06457-3654",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-358-2765",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "534 SAYBROOK RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIDDLETOWN",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06457-4754",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "860-358-2765",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/23/2006",
"LastUpdateDate": "08/17/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CAPECE",
"AuthorizedOfficialFirstName": "VINCENT",
"AuthorizedOfficialMiddleName": "G.",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "860-358-6110",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2083X0100X",
"TaxonomyName": "Occupational Medicine Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}