TINA MARIE WALLACE NPI 1285271254

NPI Information

NPI: 1285271254
Provider Name: TINA MARIE WALLACE
Classification: Optometrist - 152WV0400X
Entity Type: Individual

Specialization: Vision Therapy

Address:
1363 VETERANS MEMORIAL HWY STE 8
HAUPPAUGE, NY
ZIP 11788
Phone: (631) 366-3876
Get Directions

Tina Marie Wallace is a vision therapy optometrist in Hauppauge, NY. The provider is optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions. Tina Marie Wallace NPI is 1285271254. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1363 VETERANS MEMORIAL HWY STE 8
HAUPPAUGE, NY
ZIP 11788-046
Phone: (631) 366-3876

The enumeration date for this NPI number is 12/9/2019 and was last updated on 12/9/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	152WV0400X	Optometrist	Vision Therapy	82685981	NEW YORK	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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