Provider Demographics
NPI:1710275169
Name:ANTOINE-HYPPOLITE, MARIE B (MSW)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:B
Last Name:ANTOINE-HYPPOLITE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13625 218TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2226
Mailing Address - Country:US
Mailing Address - Phone:718-525-3414
Mailing Address - Fax:718-525-0982
Practice Address - Street 1:13625 218TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-2226
Practice Address - Country:US
Practice Address - Phone:718-525-3414
Practice Address - Fax:718-525-0982
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP807731041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool