| Doctor Name: | DR. MELINDA E DELAZAR |
| NPI Number: | 1508137472 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 019455-1 |
| Business Practice Address: | 2044 State Route 32 Suite 3 Modena, NY - 125485020 |
| Business Phone Number: | 8458833009 |
| Business Fax Number: | 8458833010 |
| Mailing Address: | 2044 State Route 32, Suite 3 MODENA |
| State: | NY |
| Postal Code: | 125485020 |
| Phone Number: | 8458833009 |
| Fax Number: | 8458833010 |
| NPI Enumeration Date: | 01/24/2012 |
| NPI Last Update Date: | 10/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 019455-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |