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General NPI Number Information
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NPI Number | 1053267369
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Entity Type | Organization
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Legal Business Name | PRINE HEALTH MEDICAL GROUP, PLLC
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 314 DEMOTT AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-1854
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Country | US
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Telephone | 516-223-4026
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 OLD COUNTRY RD STE 101N
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City | WESTBURY
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State | NY
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Zip | 11590-5119
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | SIMON ELLIOT PRINCE
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Credential |
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Telephone | 516-365-5570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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