Provider Demographics
NPI:1508177452
Name:DELA CRUZ, AILA (MD)
Entity Type:Individual
Prefix:DR
First Name:AILA
Middle Name:
Last Name:DELA CRUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 CENTRE STREET
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:ON
Mailing Address - Zip Code:L9V3R8
Mailing Address - Country:CA
Mailing Address - Phone:519-925-0017
Mailing Address - Fax:519-925-6717
Practice Address - Street 1:167 CENTRE STREET
Practice Address - Street 2:
Practice Address - City:SHELBURNE
Practice Address - State:ON
Practice Address - Zip Code:L9V3R8
Practice Address - Country:CA
Practice Address - Phone:519-925-0017
Practice Address - Fax:519-925-6717
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101253864207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine