Organization Active NPI

Heartline Diagnostics LLC

  • Physiological Laboratory
  • Valley Stream, NY
National Provider Identifier
1639543812
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
HEARTLINE DIAGNOSTICS LLC
Practice address
33 W Hawthorne Ave
Suite 22
Valley Stream, NY 11580-6207
Phone
(516) 812-8844
NPI assigned
Nov 25, 2015
Last updated
Dec 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Authorized official

Name
Sam Gormezano
Title
Member
Phone
(516) 375-2105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X NU Primary

Addresses

Primary practice location

33 W Hawthorne Ave
Suite 22
Valley Stream, NY 11580-6207

Mailing address

33 W Hawthorne Ave
Suite 22
Valley Stream, NY 11580-6207
Phone (516) 812-8844

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1448409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1639543812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W HAWTHORNE AVE",
            "address_2": "SUITE 22",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115806207",
            "telephone_number": "516-812-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W HAWTHORNE AVE",
            "address_2": "SUITE 22",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115806207",
            "telephone_number": "516-812-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLINE DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-25",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "GORMEZANO",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "516-375-2105"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.