Individual
JOANNA FASULO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
4155 VETERANS MEMORIAL HWY STE 5, RONKONKOMA, NY 11779-6063
(516) 509-0725
Mailing address
70 WILDWOOD RD, SAG HARBOR, NY 11963-2105
(516) 509-0725
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X006462
NY
Other
Enumeration date
08/08/2006
Last updated
03/13/2026
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