Provider Demographics
NPI:1508856394
Name:HYPPOLITE, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:HYPPOLITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66C BRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1160
Mailing Address - Country:US
Mailing Address - Phone:732-747-6600
Mailing Address - Fax:732-747-6001
Practice Address - Street 1:66C BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1160
Practice Address - Country:US
Practice Address - Phone:732-747-6600
Practice Address - Fax:732-747-6001
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ61388207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ538856Medicare ID - Type Unspecified
NJF94331Medicare UPIN