MEDICARE: MS. MEAGAN WIENER LMSW

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	104100000X	Social Worker	101167-1	NY

General Provider Information

NPI Number	:	1952898843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MEAGAN WIENER LMSW

Provider Business Mailing Address
First Line	:	611 NORTHERN BLVD
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-5207
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 NORTHERN BLVD
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-5207
Country	:	US
Telephone Number	:	516-325-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2018
Last Update Date	:	03/23/2026

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