| Middlesex Hospital Palliative Care Services | |
|
540 Saybrook Rd Middletown CT 06457-4711 | |
| (860) 358-2780 | |
| (860) 347-4691 |
| Full Name | Middlesex Hospital Palliative Care Services |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 540 Saybrook Rd, Middletown, Connecticut |
| Authorized Official Name and Position | Susan Martin (VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 8603586140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Middlesex Hospital Palliative Care Services 28 Crescent St Middletown CT 06457-3654 Ph: () - | Middlesex Hospital Palliative Care Services 540 Saybrook Rd Middletown CT 06457-4711 Ph: (860) 358-2780 |
| NPI Number | 1366968182 |
|---|---|
| Provider Enumeration Date | 08/15/2017 |
| Last Update Date | 07/01/2019 |
| Medicare PECOS PAC ID | 4082507371 |
|---|---|
| Medicare Enrollment ID | O20171214000461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366968182 | NPI | - | NPPES |
| Provider Name | Nicole Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508952334 PECOS PAC ID: 8628970266 Enrollment ID: I20040123000287 |
| Provider Name | Katie L Dziedzic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093019234 PECOS PAC ID: 1850575804 Enrollment ID: I20110415000300 |
| Provider Name | Rebecca Gagne Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851521215 PECOS PAC ID: 5698935237 Enrollment ID: I20120320000192 |
| Provider Name | Anju A Phillips |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285920975 PECOS PAC ID: 4486974078 Enrollment ID: I20150904001302 |
| Provider Name | Monika E Kieltyka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013361641 PECOS PAC ID: 6901197532 Enrollment ID: I20160629000006 |
| Provider Name | Christopher J Yi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467906966 PECOS PAC ID: 2860764685 Enrollment ID: I20170814003002 |
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