Healthcare Provider Details

I. General information

NPI: 1699656652
Provider Name (Legal Business Name): ANNA C DELAPAZ RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 12/10/2025
Certification Date: 09/08/2025
Deactivation Date: 09/08/2025
Reactivation Date: 12/10/2025

III. Provider practice location address

233 WESTMINSTER AVE
SYRACUSE NY
13210-3003
US

IV. Provider business mailing address

233 WESTMINSTER AVE
SYRACUSE NY
13210-3003
US

V. Phone/Fax

Practice location:
  • Phone: 214-934-7002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number011476
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: