Linda Marie Fasullo, M.S. CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

007103 Issued in NY

Practice address

5 Sturrock Way
East Setauket, NY 11733-1046

Phone

(631) 941-0103

NPI assigned

Sep 15, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1376825349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 STURROCK WAY",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331046",
            "telephone_number": "631-941-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 STURROCK WAY",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331046",
            "telephone_number": "631-941-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASULLO",
        "first_name": "LINDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "007103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elyse Everett, LCSW
• James William Every, MPT
• Eye-Q Corporation of America
• Roseann M Falcone, L.M.H.C., C.A.S.A.C.
• Kathryn Brigitte Fassnacht, CPNP
• Kenneth Michael Faulkner, MS, RN, ANP-BC
• Tara Elizabeth Fay, M.A., CCC-SLP
• Nicholas Fazio, MD
• Stefanie Claire Fedun, M.S. CCC-SLP, TSSLD
• Edward Feldman, LCSW

• Speech-Language Pathologist in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.