MID STATE MD LLC NPI 1881956514

NPI Information

  • NPI: 1881956514
  • Provider Name: MID STATE MD, LLC
  • Classification: Plastic Surgery - 208200000X
  • Entity Type: Organization
  • Address: 85 CHURCH ST STE 500
    MIDDLETOWN, CT
    ZIP 06457
  • Phone: (860) 346-8657

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NPI Details

MID STATE MD, LLC is a plastic surgery in Middletown, CT. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. MID STATE MD, LLC NPI is 1881956514. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

85 CHURCH ST STE 500
MIDDLETOWN, CT
ZIP 06457-647
Phone: (860) 346-8657
Fax: (860) 347-9554

The provider's authorized official is John J Borkowski .
The authorized official title is Member and has the following contact phone number (860) 346-8657.

The enumeration date for this NPI number is 6/8/2012 and was last updated on 6/8/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic Surgery18705CONNECTICUTYes

What is NPI?

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This page was last updated on: 11/21/2025

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