| Middlesex Hospital Dba Middlesex Hospital Psychiatric Physician Servic | |
|
28 Crescent St Middletown CT 06457-3654 | |
| (860) 358-6394 | |
| (860) 358-6748 |
| Full Name | Middlesex Hospital Dba Middlesex Hospital Psychiatric Physician Servic |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 28 Crescent St, Middletown, Connecticut |
| Authorized Official Name and Position | Vincent G. Capece (CEO) |
| Authorized Official Contact | 8603586394 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Middlesex Hospital Dba Middlesex Hospital Psychiatric Physician Servic 28 Crescent St Middletown CT 06457-3654 Ph: (860) 358-6394 | Middlesex Hospital Dba Middlesex Hospital Psychiatric Physician Servic 28 Crescent St Middletown CT 06457-3654 Ph: (860) 358-6394 |
| NPI Number | 1760451041 |
|---|---|
| Provider Enumeration Date | 03/17/2006 |
| Last Update Date | 12/19/2022 |
| Certification Date | 12/19/2022 |
| Medicare PECOS PAC ID | 5092611731 |
|---|---|
| Medicare Enrollment ID | O20060912000506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760451041 | NPI | - | NPPES |
| CK1085 | Other | CT | RR MEDICARE |
| Provider Name | Luis R Gonzalez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801863220 PECOS PAC ID: 2567350408 Enrollment ID: I20040310000888 |
| Provider Name | Benjamin J Zigun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083682900 PECOS PAC ID: 2668452228 Enrollment ID: I20040723000318 |
| Provider Name | Sergio Mejia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932127214 PECOS PAC ID: 9830148329 Enrollment ID: I20050122000030 |
| Provider Name | Velandy Manohar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356322952 PECOS PAC ID: 5991709438 Enrollment ID: I20060914000194 |
| Provider Name | Jean Carl Jarda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669402343 PECOS PAC ID: 9335244946 Enrollment ID: I20070410000290 |
| Provider Name | Tariq Latif |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992844419 PECOS PAC ID: 5698876316 Enrollment ID: I20070725000479 |
| Provider Name | Janine Fonfara |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124215546 PECOS PAC ID: 9830187863 Enrollment ID: I20080429000472 |
| Provider Name | Maryann Kelly |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1760658207 PECOS PAC ID: 8729159314 Enrollment ID: I20080626000001 |
| Provider Name | Jeffrey T Shelton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366641839 PECOS PAC ID: 5991877011 Enrollment ID: I20080708000035 |
| Provider Name | Aleksandra S Phillips |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316018450 PECOS PAC ID: 7012969439 Enrollment ID: I20081114000257 |
| Provider Name | Christopher L Yergen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386844611 PECOS PAC ID: 1456409887 Enrollment ID: I20090423000251 |
| Provider Name | Beth Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871669267 PECOS PAC ID: 6901939396 Enrollment ID: I20100805000705 |
| Provider Name | Bindu Lal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598935389 PECOS PAC ID: 1658541552 Enrollment ID: I20110901000524 |
| Provider Name | Erin Cordero |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902034044 PECOS PAC ID: 2961629647 Enrollment ID: I20140805000657 |
| Provider Name | Anita Chu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255590329 PECOS PAC ID: 7113148784 Enrollment ID: I20141023001585 |
| Provider Name | Virena C Hermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588610430 PECOS PAC ID: 8820091358 Enrollment ID: I20141106000324 |
| Provider Name | Marilise A Hyacinth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528324530 PECOS PAC ID: 0648596163 Enrollment ID: I20150227001242 |
| Provider Name | Michelle Mirsky |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396168464 PECOS PAC ID: 7810215985 Enrollment ID: I20150422000063 |
| Provider Name | Cristina Sanchez-torres |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801104872 PECOS PAC ID: 8426363409 Enrollment ID: I20150820009770 |
| Provider Name | Courtney Ackley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518340553 PECOS PAC ID: 3870883382 Enrollment ID: I20160610001479 |
| Provider Name | Susan J. Meunier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144662156 PECOS PAC ID: 8921399544 Enrollment ID: I20160628003046 |
| Provider Name | Mahreen Raza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154638815 PECOS PAC ID: 7416240122 Enrollment ID: I20160718002132 |
| Provider Name | Patrice Janell Holmes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710204987 PECOS PAC ID: 9234427097 Enrollment ID: I20161011000555 |
| Provider Name | Michael P Miarecki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821426149 PECOS PAC ID: 3870873813 Enrollment ID: I20161208000135 |
| Provider Name | Jill H White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588052963 PECOS PAC ID: 5193019107 Enrollment ID: I20170405000350 |
| Provider Name | Ashley F Coughlin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528445871 PECOS PAC ID: 3779847579 Enrollment ID: I20180502002353 |
| Provider Name | Samantha J Dippolino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952748634 PECOS PAC ID: 6406136035 Enrollment ID: I20190828003466 |
| Provider Name | Hamilton Gaiani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508276627 PECOS PAC ID: 9830402981 Enrollment ID: I20191108000470 |
| Provider Name | Kaveh Ghaedi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235576224 PECOS PAC ID: 5395768584 Enrollment ID: I20200410001042 |
| Provider Name | Daniel Carrero |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194144287 PECOS PAC ID: 3870916752 Enrollment ID: I20200710001372 |
| Provider Name | Jeffrey S Gold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245364975 PECOS PAC ID: 5597941294 Enrollment ID: I20201118000266 |
| Provider Name | Ryan Allen Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366062622 PECOS PAC ID: 8426469214 Enrollment ID: I20201130002678 |
| Provider Name | Josephine Eunjung Henriquez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962964122 PECOS PAC ID: 7214329804 Enrollment ID: I20220111000897 |
| Provider Name | Santiago Castro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467942730 PECOS PAC ID: 7911254172 Enrollment ID: I20220823002760 |
| Provider Name | Heeryoung Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639673403 PECOS PAC ID: 8527319490 Enrollment ID: I20220829003757 |
| Provider Name | Eric A Gambardella |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518428432 PECOS PAC ID: 7214267418 Enrollment ID: I20230713002342 |
| Provider Name | Elizabeth Cameron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598448078 PECOS PAC ID: 3577917210 Enrollment ID: I20230928001557 |
| Provider Name | Brett Scott Rayford |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922738392 PECOS PAC ID: 9638517626 Enrollment ID: I20240410001397 |
One Piece Of The Puzzle, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 460 Smith St, Suite L, Middletown, CT 06457 Phone: 860-990-0776 Fax: 860-904-2839 | |
Pursuecare Connecticut Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 101 Centerpoint Dr Ste 105, Middletown, CT 06457 Phone: 860-317-5251 Fax: 860-469-2766 | |
Mindrise Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 54 Forest St, Middletown, CT 06457 Phone: 203-999-2777 | |
The Connection, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Roscommon Dr, Middletown, CT 06457 Phone: 860-343-5500 Fax: 860-343-5509 | |
Blue Hills Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 S Main St, Middletown, CT 06457 Phone: 860-852-3860 Fax: 860-852-3860 | |
Whole Heart Art Therapy & Creative Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 955 S Main St # B201, Middletown, CT 06457 Phone: 203-533-2351 | |
Crescent Counseling And Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Carriage Crossing Ln, Middletown, CT 06457 Phone: 203-449-8299 |