Healthcare Provider Details

I. General information

NPI: 1073690566
Provider Name (Legal Business Name): TLC DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MAIN ST
EAST ROCKAWAY NY
11518-1929
US

IV. Provider business mailing address

50 MAIN ST
EAST ROCKAWAY NY
11518-1929
US

V. Phone/Fax

Practice location:
  • Phone: 516-887-8870
  • Fax: 516-887-0175
Mailing address:
  • Phone: 516-887-8870
  • Fax: 516-887-0175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN LAROSA
Title or Position: PRESIDENT/CEO
Credential:
Phone: 516-640-6535