National Provider Identifier
Ethan James Hargrave
Ethan James Hargrave is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Penn Yan, NY and a listed phone number of (302) 494-7186.
Profile Overview
- NPI
- 1528945284
- Provider Type
- Individual
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- August 16, 2025
- Last Updated
- August 16, 2025
Practice Location
- 1793 Outlet RD
- Penn Yan, NY 14527-8750
Phone: (302) 494-7186
Mailing Address
- 45 Hollister St
- Dundee, NY 14837-1120
Specialties
- Licensed Practical Nurse (164W00000X)
Full Record
- NPI
- 1528945284
- Entity Type
- Individual
- Last Name
- Hargrave
- First Name
- Ethan
- Middle Name
- James
- Mailing Street Address
- 45 Hollister St
- Mailing City
- Dundee
- Mailing State
- NY
- Mailing ZIP Code
- 14837-1120
- Mailing Country
- US
- Mailing Phone
- (607) 794-7270
- Practice Street Address
- 1793 Outlet RD
- Practice City
- Penn Yan
- Practice State
- NY
- Practice ZIP Code
- 14527-8750
- Practice Country
- US
- Practice Phone
- (302) 494-7186
- Enumeration Date
- August 16, 2025
- Last Updated
- August 16, 2025
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- August 16, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Licensed Practical Nurse (164W00000X)