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TINA MARIE WALLACE
NPI 1285271254
Optometrist - Vision Therapy in Hauppauge, NY

Active since December 09, 2019
1363 VETERANS MEMORIAL HWY STE 8, HAUPPAUGE, NY 11788(631) 366-3876 Get Directions Write a Review

NPPES record last updated: December 9, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Tina Marie Wallace NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TINA MARIE WALLACE (NPI 1285271254) is an individual vision therapy provider in Hauppauge, New York, licensed in New York (82685981) and active in the NPI registry since December 2019.

NPPES Registry Identity

NPI1285271254
Entity TypeIndividualFemale
Primary Taxonomy152WV0400X
Provider Legal NameTINA MARIE WALLACE
Location Address1363 VETERANS MEMORIAL HWY STE 8Hauppauge, NY 11788-3046
Mailing Address124 South PathCalverton, NY 11933-1135 · (631) 831-6676
Phone(631) 366-3876
Sole ProprietorNo
Enumeration DateDecember 9, 2019
✔ NPI 1285271254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometrist · Vision TherapyEye and Vision Services Providers
Taxonomy Code152WV0400X
License✔ Licensed in NY · 82685981
Definition
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.
1363 VETERANS MEMORIAL HWY STE 8, Hauppauge, NY 11788
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAURA GIBBONS
Speech-Language Pathologist
1363 VETERANS MEMORIAL HWY STE 8
HAUPPAUGE, NY 11788
Suffolk County (631) 366-3876
ROSEANNE BRODSKY MSED
Behavior Analyst
1363 VETERANS MEMORIAL HWY STE 8
HAUPPAUGE, NY 11788
Suffolk County (631) 366-3876
KATHERINE LOPEZ
Specialist/Technologist, Other
1363 VETERANS MEMORIAL HWY STE 8
HAUPPAUGE, NY 11788
Suffolk County (631) 366-3876
KRISTEN BYRNE OTR/L
Occupational Therapist
1363 VETERANS MEMORIAL HWY STE 8
HAUPPAUGE, NY 11788
Suffolk County (631) 366-3876
KAITLYN SULLIVAN
Occupational Therapist
1363 VETERANS MEMORIAL HWY STE 8
HAUPPAUGE, NY 11788
Suffolk County (631) 366-3876
KIMBERLY QUINTERO
Psychologist (School)
1363 VETERANS MEMORIAL HWY STE 8
HAUPPAUGE, NY 11788
Suffolk County (631) 366-3876
CHRISTIE ANNE LAU BCBA
Behavior Analyst
1363 VETERANS MEMORIAL HWY STE 8
HAUPPAUGE, NY 11788
Suffolk County (631) 366-3876
SAMANTHA AVRUTINE OTR/L
Occupational Therapist
1363 VETERANS MEMORIAL HWY STE 8
HAUPPAUGE, NY 11788
Suffolk County (631) 366-3876

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tina Wallace's NPI number?

The NPI number for Tina Wallace is 1285271254. It was assigned to this individual provider in the NPPES registry on December 9, 2019.

Where is Tina Wallace located?

Tina Wallace practices at 1363 Veterans Memorial Hwy Ste 8, Hauppauge, NY 11788. The listed phone number is (631) 366-3876.

What is Tina Wallace's specialty?

The primary specialty registered for this NPI is Optometrist, specializing in Vision Therapy, with taxonomy code 152WV0400X.

When was this NPI record last updated?

The NPPES record for Tina Wallace was last updated on December 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.