PRINE PODIATRY
NPI 1053074658
Durable Medical Equipment & Medical Supplies in Hicksville, NY

Active since October 20, 2021CLIA 33D2173761 · Waiver
400 S OYSTER BAY RD STE 308, HICKSVILLE, NY 11801(516) 365-5570 Get Directions Write a Review

NPPES record last updated: October 25, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Prine Podiatry NPPES

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

PRINE PODIATRY (NPI 1053074658) is a healthcare organization registered as a durable medical equipment & medical supplies in Hicksville, New York and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through October 17, 2027 and lists Georgia Haynes, Administrator, as its authorized official.

NPPES Registry Identity

NPI1053074658
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NamePRINE HEALTH MEDICAL GROUP, PLLC
Location Address400 S OYSTER BAY RD STE 308Hicksville, NY 11801-3500
Mailing Address370 Old Country Rd Ste 100Garden City, NY 11530-1702 · (516) 365-5570
Organization SubpartNo
Authorized OfficialGeorgia HaynesAdministrator · (516) 407-2731
Enumeration DateOctober 20, 2021
Last NPPES UpdateOctober 25, 2021
NPPES CertifiedOctober 25, 2021
NPI 1053074658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

400 S OYSTER BAY RD STE 308, Hicksville, NY 11801

Other Names 1

Doing Business AsPrine Podiatry

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
33D2173761
Facility Type
Physician Office
Certificate Effective Date
October 18, 2025
Certificate Expiration Date
October 17, 2027
Laboratory Director
DR. SIMON E. PRINCE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Prine Podiatry to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Internal Medicine
400 S OYSTER BAY RD STE 308
HICKSVILLE, NY 11801

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053074658, enumerated as an "organization" on October 20, 2021.

The provider is located at 400 S OYSTER BAY RD STE 308 HICKSVILLE, NY 11801 and the phone number is (516) 365-5570.

Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.