Bottizer Radiological PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

114648-1 Issued in NY

Legal business name

BOTTIZER RADIOLOGICAL PC

Practice address

201 Portion Rd
Suite B
Ronkonkoma, NY 11779-4172

Phone

(516) 872-7001

Fax

(516) 872-7007

NPI assigned

Oct 15, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Walter E. Bottizer, M.D.

Title

Medical Director

Phone

(516) 872-7001

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381795200000",
    "number": "1467880286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PORTION RD",
            "address_2": "SUITE B",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117794172",
            "telephone_number": "516-872-7001",
            "fax_number": "516-872-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PORTION RD",
            "address_2": "SUITE B",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117794172",
            "telephone_number": "516-872-7001",
            "fax_number": "516-872-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTTIZER RADIOLOGICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-15",
        "last_updated": "2013-10-15",
        "status": "A",
        "authorized_official_last_name": "BOTTIZER",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "516-872-7001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "114648-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lissa Boileau
• Frank William Bonnici, CEP
• Stephen John Boose, LMSW
• Ted Borkstrom, CASAC
• Tara Botter, RN
• Maryanne Bounaparte, LMT
• Tailer Boutin
• Amanda Brett, MHC-LP
• Sebastien Bright
• Brightwater Laboratories, Inc.

• Diagnostic Radiology Physician in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.