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General NPI Number Information
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NPI Number | 1972573947
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Entity Type | Individual
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Provider Name | CYNTHIA W. DELAGO M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 5501 OLD YORK RD 1ST FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3018
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Country | US
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Telephone | 215-456-7171
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Fax | 215-456-3436
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Provider Business Mailing Address
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Address Line | 5501 OLD YORK RD 1ST FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3018
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Country | US
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Telephone | 215-456-7170
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Fax | 215-456-3434
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MA05268400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2080C0008X
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Taxonomy Name | Child Abuse Pediatrics Physician
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License Number | 25MA05268400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD039793E
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License Number State | PA
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