Provider Demographics
NPI:1629171079
Name:CARDIOLINK CORP
Entity Type:Organization
Organization Name:CARDIOLINK CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAMMERER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:516-394-7420
Mailing Address - Street 1:1 NORTH VILLAGE GREEN
Mailing Address - Street 2:SUITE 1-F
Mailing Address - City:LEVITTONN
Mailing Address - State:NY
Mailing Address - Zip Code:11756
Mailing Address - Country:US
Mailing Address - Phone:516-394-7420
Mailing Address - Fax:516-520-6231
Practice Address - Street 1:1 NORTH VILLAGE GREEN
Practice Address - Street 2:SUITE 1-F
Practice Address - City:LEVITTONN
Practice Address - State:NY
Practice Address - Zip Code:11756
Practice Address - Country:US
Practice Address - Phone:516-394-7420
Practice Address - Fax:516-520-6231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02110543Medicaid
NY02110543Medicaid
NY97Z371Medicare ID - Type Unspecified
NY0920000001Medicare NSC