Provider Demographics
NPI:1780050815
Name:WESTBLADE, LARS FREDERICK (PHD)
Entity type:Individual
Prefix:DR
First Name:LARS
Middle Name:FREDERICK
Last Name:WESTBLADE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:WEILL CORNELL MEDICAL COLLEGE
Mailing Address - Street 2:1300 YORK AVENUE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7940
Mailing Address - Country:US
Mailing Address - Phone:212-746-6464
Mailing Address - Fax:
Practice Address - Street 1:WEILL CORNELL MEDICAL COLLEGE
Practice Address - Street 2:1300 YORK AVENUE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7940
Practice Address - Country:US
Practice Address - Phone:212-746-6464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYWESTL2247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician