Watertown Breast Imaging Consultants, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

WATERTOWN BREAST IMAGING CONSULTANTS, LLC

Practice address

428 Washington St
Watertown, NY 13601-3736

Phone

(315) 782-2620

Fax

(315) 788-4980

NPI assigned

May 31, 2006

Organization subpart

No

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

Authorized official

Name

Christine Crump, CCSP

Title

Hipaa Compliance Officer

Phone

(315) 782-2620

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glauco Michael Maresca, MD

  • Diagnostic Radiology Physician
  • Potsdam, NY
  • NPI 1053370742
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902843832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012229",
            "telephone_number": "315-782-2620",
            "fax_number": "315-788-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013736",
            "telephone_number": "315-782-2620",
            "fax_number": "315-788-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN BREAST IMAGING CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRUMP",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "HIPAA COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "315-782-2620",
        "authorized_official_credential": "CCSP"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah V Warner, LCAT
• Charles August Wasicek, MD
• Clinton Robert Waters Jr., D.M.D.
• Watertown Adult Social Daycare Inc
• Watertown Audiology PC
• Watertown City School District
• Watertown Dental Health Group, PC
• Watertown Dialysis Center, LLC
• Watertown Ear Nose and Throat GRP
• Watertown Hearing Aid Center Inc

• Diagnostic Radiology Physician in Watertown, NY
• Providers in Watertown, 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 Aug 22, 2020; 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.