Provider Demographics
NPI:1952606782
Name:HYPPOLITE, SOLEDAD (LPN)
Entity Type:Individual
Prefix:
First Name:SOLEDAD
Middle Name:
Last Name:HYPPOLITE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 W MAIN ST
Mailing Address - Street 2:APT 2
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-8911
Mailing Address - Country:US
Mailing Address - Phone:845-360-5312
Mailing Address - Fax:
Practice Address - Street 1:252 MAIN ST
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-2178
Practice Address - Country:US
Practice Address - Phone:845-294-8364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285630164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse