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PRINE HEALTH IPA, LLC

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Company Details

Name: PRINE HEALTH IPA, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 01 Feb 2019 (6 years ago)
Entity Number: 5486638
ZIP code: 11030
County: Nassau
Place of Formation: New York
Address: 1129 NORTHERN BLVD., SUITE 101, MANHASSET, NY, United States, 11030

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 1129 NORTHERN BLVD., SUITE 101, MANHASSET, NY, United States, 11030

National Provider Identifier

NPI Number:
1003485202
Certification Date:
2021-06-29

Authorized Person:

Name:
KRISTIN MERLO
Role:
PROVIDER RELATIONS
Phone:

Taxonomy:

Selected Taxonomy:
207RN0300X - Nephrology Physician
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
190430001099 2019-04-30 CERTIFICATE OF PUBLICATION 2019-04-30
190201000224 2019-02-01 ARTICLES OF ORGANIZATION 2019-02-01

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Date of last update: 23 Mar 2025

Sources: New York Secretary of State