Provider Demographics
NPI:1619583994
Name:DELA CRUZ, ISABELLA LAPUZ
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:LAPUZ
Last Name:DELA CRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28145 EATON DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-5527
Mailing Address - Country:US
Mailing Address - Phone:586-746-4981
Mailing Address - Fax:
Practice Address - Street 1:18463 LIVERNOIS AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-2254
Practice Address - Country:US
Practice Address - Phone:313-861-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant