Individual
IAN RODEL AGNOTE RECTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, CRNA
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(951) 742-3453
Mailing address
3400 SPRUCE ST, DULLES BLDG, STE 680, PHILADELPHIA, PA 19104-4238
(951) 742-3453
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN737666
PA
Other
Enumeration date
06/29/2024
Last updated
09/24/2024
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