Provider Demographics
NPI:1114449352
Name:HYPPOLITE, VIRGINIA
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:HYPPOLITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LISZKA LN
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1657
Mailing Address - Country:US
Mailing Address - Phone:732-979-4171
Mailing Address - Fax:
Practice Address - Street 1:10 LISZKA LN
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-1657
Practice Address - Country:US
Practice Address - Phone:732-979-4171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0253600374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide