Active NPI
Joanna Fasulo DC PC
Doing business as Fasulo Chiropractic
- Chiropractor
- Ronkonkoma, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X006462
- Legal business name
- JOANNA FASULO DC PC
- Doing business as
- Fasulo Chiropractic
- Practice address
- 4155 Veterans Memorial Hwy Ste 5
Ronkonkoma, NY 11779-6063 - Phone
- (516) 509-0725
- NPI assigned
- Dec 29, 2011
- Last updated
- Mar 13, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joanna Fasulo, DC
- Title
- Owner
- Phone
- (516) 509-0725
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X006462 | NY | Primary |
Addresses
Primary practice location
4155 Veterans Memorial Hwy Ste 5
Ronkonkoma, NY 11779-6063
Mailing address
70 Wildwood Road Sag
Harbor, NY 11937
Phone (516) 509-0725
Other practice location 1
70 Wildwood Rd
Sag Harbor, NY 11963-2105
Phone (516) 509-0725
Other names 1
- Fasulo Chiropractic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
4155 Veterans Memorial Hwy
Ste 5
Ronkonkoma, NY 11779
Phone (516) 205-6627
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Chiropractor
- Ronkonkoma, NY
- NPI 1710997283
-
- Chiropractor
- East Islip, NY
- NPI 1922663095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325116800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773360000000",
"number": "1336418847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 WILDWOOD ROAD SAG",
"city": "HARBOR",
"state": "NY",
"postal_code": "11937",
"telephone_number": "516-509-0725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4155 VETERANS MEMORIAL HWY STE 5",
"city": "RONKONKOMA",
"state": "NY",
"postal_code": "117796063",
"telephone_number": "516-509-0725"
}
],
"practiceLocations": [
{
"address_1": "70 Wildwood Rd",
"address_purpose": "LOCATION",
"city": "Sag Harbor",
"state": "NY",
"postal_code": "119632105",
"country_code": "US",
"telephone_number": "516-509-0725",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "JOANNA FASULO DC PC",
"organizational_subpart": "NO",
"enumeration_date": "2011-12-29",
"last_updated": "2026-03-13",
"certification_date": "2026-03-13",
"status": "A",
"authorized_official_last_name": "FASULO",
"authorized_official_first_name": "JOANNA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "516-509-0725",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X006462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Fasulo Chiropractic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Ronkonkoma, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.