# HEARTLINE DIAGNOSTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639543812
- **Authorized official:** SAM GORMEZANO (MEMBER)
- **Authorized official phone:** (516) 375-2105

## Contact information

- **Practice address:** 33 W HAWTHORNE AVE, SUITE 22, VALLEY STREAM, NY 11580-6207
- **Practice address phone:** (516) 812-8844
- **Mailing address:** 33 W HAWTHORNE AVE, SUITE 22, VALLEY STREAM, NY 11580-6207
- **Mailing address phone:** (516) 812-8844

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | — | NULL | Yes |

## Other

- **Enumeration date:** 11/25/2015
- **Last updated:** 12/02/2015