Healthcare Provider Details

I. General information

NPI: 1548176092
Provider Name (Legal Business Name): DR. DIANA D'ANGELO CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 PETER PAUL DR
WEST ISLIP NY
11795-3516
US

IV. Provider business mailing address

608 PETER PAUL DR
WEST ISLIP NY
11795-3516
US

V. Phone/Fax

Practice location:
  • Phone: 516-639-6128
  • Fax:
Mailing address:
  • Phone: 516-639-6128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. DIANA A D'ANGELO
Title or Position: MANAGING MEMBER
Credential: DC
Phone: 516-639-6128