Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tina Marie Wallace

Individual provider Vision Therapy Optometrist · NPI 1285271254

Tina Marie Wallace is a Vision Therapy Optometrist in Hauppauge, New York. Licensed in New York. Registered with an NPI since 2019.

Licensed in
NY
In the registry since
2019
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Practice location Address checks out

1363 Veterans Memorial Hwy Ste 8
Hauppauge, NY 11788-3046
Phone: (631) 366-3876
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vision Therapy Optometrist (primary) Taxonomy 152WV0400X · Licence 82685981 (NY)

Record details

NPI number1285271254
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 9, 2019
Last updated in NPPESDecember 9, 2019
Certification dateDecember 9, 2019