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WATERTOWN BREAST IMAGING CONSULTANTS, LLC

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Company Details

Name: WATERTOWN BREAST IMAGING CONSULTANTS, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 06 Jul 2000 (25 years ago)
Entity Number: 2528582
ZIP code: 13601
County: Jefferson
Place of Formation: New York
Address: 428 WASHINGTON STREET, SUITE 2, WATERTOWN, NY, United States, 13601

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 428 WASHINGTON STREET, SUITE 2, WATERTOWN, NY, United States, 13601

National Provider Identifier

NPI Number:
1902843832

Authorized Person:

Name:
CHRISTINE CRUMP
Role:
HIPAA COMPLIANCE OFFICER
Phone:

Taxonomy:

Selected Taxonomy:
2085R0202X - Diagnostic Radiology Physician
Is Primary:
Yes

Contacts:

Fax:
3157884980

Filings

Filing Number Date Filed Type Effective Date
060714002107 2006-07-14 BIENNIAL STATEMENT 2006-07-01
040701002027 2004-07-01 BIENNIAL STATEMENT 2004-07-01
020624002120 2002-06-24 BIENNIAL STATEMENT 2002-07-01
000912000117 2000-09-12 AFFIDAVIT OF PUBLICATION 2000-09-12
000912000127 2000-09-12 AFFIDAVIT OF PUBLICATION 2000-09-12

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Date of last update: 30 Mar 2025

Sources: New York Secretary of State