Organization
PROVIDENTIAL MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HYPPOLITE MD (OWNER)
(732) 747-6600
Entity
Organization
Contact information
Practice address
66 BRIDGE AVE # C, RED BANK, NJ 07701-6410
(732) 747-6600
Mailing address
66 BRIDGE AVE # C, RED BANK, NJ 07701-6410
(732) 747-6001
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA61338
NJ
Other
Enumeration date
09/16/2007
Last updated
02/14/2011
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