Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Middlesex Hospital Dba Family Practice Group East Hampton

Organization Family Medicine Physician · NPI 1114062114

Middlesex Hospital Dba Family Practice Group East Hampton is a Family Medicine Physician in East Hampton, Connecticut. Licensed in Connecticut. Registered with an NPI since 2007.

Licensed in
CT
In the registry since
2007
Specialties on file
5

Practice location Address checks out

42 E High St
East Hampton, CT 06424-1099
Phone: (860) 344-6394
Fax: (860) 344-6748
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (CT)
Geriatric Medicine (Family Medicine) Physician Taxonomy 207QG0300X (CT)
Obstetrics & Gynecology Physician Taxonomy 207V00000X (CT)
Pediatrics Physician Taxonomy 208000000X (CT)
Medical Physician Assistant Taxonomy 363AM0700X (CT)

Record details

NPI number1114062114
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMiddlesex Hospital
Authorized official Marisa Pellerin — Credentialing/Enrollment · (860) 358-4821
Other names Family Practice Group East Hampton; Family Practice Group East Hampton
NPI enumeratedFebruary 20, 2007
Last updated in NPPESMarch 6, 2019
Mailing address90 S Main St, Middletown, CT 06457-3649

Other providers in East Hampton