=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821883844
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | M & W OPTOMETRY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2025
-----------------------------------------------------
Last Update Date | 11/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1239 N COUNTRY RD STE 3
-----------------------------------------------------
City | STONY BROOK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11790-1920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-376-4161
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1239 N COUNTRY RD STE 3
-----------------------------------------------------
City | STONY BROOK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11790-1920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-706-0004
-----------------------------------------------------
Fax | 631-343-5594
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | CYNTHIA J WIENER
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 631-706-0004
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------