Active NPI
Joseph Detullio, DC
- Chiropractor
- Pleasant Valley, NY
National Provider Identifier
1730240532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X2779
- Practice address
- RT 44 and North Ave
Pleasant Valley, NY 12569 - Phone
- (845) 635-1200
- Fax
- (845) 635-1637
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X2779 | NY | Primary |
Addresses
Primary practice location
RT 44 and North Ave
Pleasant Valley, NY 12569
Mailing address
PO Box 739
RT 44 and North Ave
Pleasant Valley, NY 12569
Phone (845) 635-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X2779 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730240532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 739",
"address_2": "RT 44 AND NORTH AVE",
"city": "PLEASANT VALLEY",
"state": "NY",
"postal_code": "12569",
"telephone_number": "845-635-1200",
"fax_number": "845-635-1637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RT 44 AND NORTH AVE",
"city": "PLEASANT VALLEY",
"state": "NY",
"postal_code": "12569",
"telephone_number": "845-635-1200",
"fax_number": "845-635-1637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETULLIO",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X2779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Valley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.