Individual
RUSSELL A HARGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5501 OLD YORK RD, TOWER 3, PHILADELPHIA, PA 19141-3018
(215) 456-3958
(215) 456-8539
Mailing address
50 N LA CIENEGA BLVD, STE 203, BEVERLY HILLS, CA 90211-2246
(215) 456-7000
(215) 254-3289
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN578914
PA
Other
Enumeration date
09/08/2010
Last updated
08/17/2016
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