Providential Medical Center PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA61338 Issued in NJ

Legal business name

PROVIDENTIAL MEDICAL CENTER PC

Practice address

66 Bridge Ave # C
Red Bank, NJ 07701-6410

Phone

(732) 747-6600

NPI assigned

Sep 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Hyppolite, MD

Title

Owner

Phone

(732) 747-6600

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vanessa Page, NP

  • Gerontology Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1932622115
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1487840203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 BRIDGE AVE # C",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077016410",
            "fax_number": "732-747-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 BRIDGE AVE # C",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077016410",
            "telephone_number": "732-747-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENTIAL MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-16",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "HYPPOLITE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-747-6600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA61338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Price, PTA
• Joanna McGill Primont, M.A. CCC/SLP
• Professional Occupational & Physical Therapy, PLLC
• Jill Propper, LMT
• Annette Cecile Provencher, MSW LCSW
• Psychology Associates
• Theresa Pugliese, PNP
• Erica Pulido, LAC
• Pure Health Chiropractic LLC
• Pure Health Services

• Specialist in Red Bank, NJ
• Providers in Red Bank, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.