Prine Health Medical Group, PLLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRINE HEALTH MEDICAL GROUP, PLLC

Practice address

400 S Oyster Bay Rd Ste 308
Hicksville, NY 11801-3500

Phone

(516) 365-5570

NPI assigned

Oct 20, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Georgia Haynes

Title

Administrator

Phone

(516) 407-2731

Specialties & licenses 1

Addresses

Other names 1

• PRINE Podiatry Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1053074658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 OLD COUNTRY RD STE 100",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301702",
            "telephone_number": "516-365-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S OYSTER BAY RD STE 308",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013500",
            "telephone_number": "516-365-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINE HEALTH MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-407-2731"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRINE Podiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PRINE Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.