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BOTTIZER RADIOLOGICAL P.C.

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Company Details

Name: BOTTIZER RADIOLOGICAL P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 15 Jul 2013 (12 years ago)
Entity Number: 4431279
ZIP code: 11779
County: Suffolk
Place of Formation: New York
Address: 201 PORTION ROAD, SUITE B, RONKONKOMA, NY, United States, 11779

Shares Details

Shares issued 20000

Share Par Value 1

Type PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 201 PORTION ROAD, SUITE B, RONKONKOMA, NY, United States, 11779

National Provider Identifier

NPI Number:
1467880286

Authorized Person:

Name:
DR. WALTER E. BOTTIZER
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

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

Contacts:

Fax:
5168727007

Filings

Filing Number Date Filed Type Effective Date
130715001505 2013-07-15 CERTIFICATE OF INCORPORATION 2013-07-15

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State