Organization · Type 2 NPI

Middlesex Hospital dba Family Practice Group East Hampton

Family Medicine Physician · East Hampton, CT

NPI number 1114062114 Active

Practice location

42 E High St
East Hampton, CT 06424-1099

Call (860) 344-6394 Map

Fax (860) 344-6748

Mailing address

90 S Main St
Middletown, CT 06457-3649

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Geriatric Medicine (Family Medicine) Physician	207QG0300X	None listed
Obstetrics & Gynecology Physician	207V00000X	None listed
Pediatrics Physician	208000000X	None listed
Medical Physician Assistant	363AM0700X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2 other providers at this address

NPI record

NPI: 1114062114
Entity type: Organization (Type 2)
Issued: Feb 20, 2007
Last updated: Mar 6, 2019
Status: Active
Subpart: Yes of Middlesex Hospital

Other names

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Family Practice Group East Hampton · doing business as
Family Practice Group East Hampton · doing business as

Authorized official

Marisa Pellerin
Credentialing/enrollment
(860) 358-4821

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1114062114

Middlesex Hospital dba Family Practice Group East Hampton's National Provider Identifier is 1114062114, issued on Feb 20, 2007. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in East Hampton, CT. The record was last updated on Mar 6, 2019.