Healthcare Provider Details
I. General information
NPI: 1083536585
Provider Name (Legal Business Name): MW EYEWEAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
243 HALSEY ST
NEWARK NJ
07102-3746
US
IV. Provider business mailing address
243 HALSEY ST APT 5A
NEWARK NJ
07102-3750
US
V. Phone/Fax
- Phone: 973-323-4949
- Fax:
- Phone: 973-323-4949
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 156FX1800X |
| Taxonomy | Optician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MONICA
WILBURN
Title or Position: LICENSED OPTICIAN
Credential: LDO
Phone: 862-237-6262