Healthcare Provider Details

I. General information

NPI: 1033742986
Provider Name (Legal Business Name): MOLLY ELISABETH DELA CRUZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100
APO AE
09180
US

IV. Provider business mailing address

PSC 405 BOX 6212
APO AE
09034-0063
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-7018
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101273224
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: