Provider First Line Business Practice Location Address:
28 CRESCENT STREET
Provider Second Line Business Practice Location Address:
MIDDLESEX HOSPITAL, DEPARTMENT OF PSYCHIATRY
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06457-3654
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-358-6497
Provider Business Practice Location Address Fax Number:
860-358-6850
Provider Enumeration Date:
05/17/2007