Provider Demographics
NPI:1285959486
Name:HYPPOLITE, SOPHONIE (LPN)
Entity type:Individual
Prefix:
First Name:SOPHONIE
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 1:10110 AVENUE L FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4410
Mailing Address - Country:US
Mailing Address - Phone:347-509-9964
Mailing Address - Fax:
Practice Address - Street 1:10110 AVENUE L FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4410
Practice Address - Country:US
Practice Address - Phone:347-509-9964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299976-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse