there is a Middlesex Community College in Connecticut, Massachusetts, and New Jersey
there is a Middlesex County in Connecticut, Massachusetts, New Jersey, and Virginia, as well as Ontario Canada, England, and Jamaica
there is a town/city named Middlesex in Maryland, Virginia, Vermont, New Jersey, Pennsylvania, Ohio, New York, and North Carolina (possibly 2 of them, might just fall in 2 counties??) also there is Middlesex Beach in Delaware, Middlesex Downs in New Jersey, and Middlesex Village in Massachussetes