MEDICARE: M & W OPTOMETRY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1821883844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M & W OPTOMETRY, PLLC

Provider Business Mailing Address
First Line	:	1239 N COUNTRY RD STE 3
Second Line	:
City	:	STONY BROOK
State	:	NY
Zip	:	11790-1920
Country	:	US
Telephone Number	:	631-706-0004
Fax Number	:	631-343-5594

Provider Business Practice Location Address
First Line	:	1239 N COUNTRY RD STE 3
Second Line	:
City	:	STONY BROOK
State	:	NY
Zip	:	11790-1920
Country	:	US
Telephone Number	:	516-376-4161
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	CYNTHIA J WIENER
Credential	:	OD
Telephone Number	:	631-706-0004

Provider Enumeration Date	:	04/10/2025
Last Update Date	:	11/11/2025

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