Individual provider · Type 1 NPI
Carissa A. Webster-Lake, MD
Vascular Surgery Physician · West Hartford, CT
NPI number
1134448269
Active
Practice location
2550 Albany Ave # 1056
West Hartford, CT 06117-2335
Other practice locations
- 500 J Clyde Morris Blvd # 603, Newport News, VA 23601-1929 · (757) 534-5340
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgery Physician | 208600000X | 54698 (CT) |
| Vascular Surgery Physician | 2086S0129X | 54698 (CT) |
| Vascular Surgery Physician | 2086S0129X | 0101279557 (VA) |
| Vascular Surgery Physician Primary | 2086S0129X | 59921 (TN) |
Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
About NPI 1134448269
Carissa A. Webster-Lake, MD's National Provider Identifier is 1134448269, issued on May 28, 2010. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in West Hartford, CT. The record was last updated on Aug 28, 2024.