HIPAA Notice of Privacy Practices

Effective Date: December 25, 2025

This Notice of Privacy Practices describes how medical information about you may be used and disclosed, and how you can access this information. Please review it carefully.

Our Commitment to Your Privacy

We are required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice of our legal duties and privacy practices, and follow the terms of this Notice currently in effect.

Protected health information includes information that identifies you and relates to your past, present, or future physical or mental health condition, the provision of healthcare to you, or payment for that care.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. This includes sharing information with physicians, nurses, laboratories, pharmacies, and other healthcare providers involved in your care.

Payment

We may use and disclose your PHI to obtain payment for healthcare services provided to you. This may include billing your insurance company, verifying coverage, or collecting payment.

Healthcare Operations

We may use and disclose your PHI for practice operations such as quality assessment, staff training, licensing, accreditation, and business management activities.

Other Permitted or Required Disclosures

We may disclose your PHI without your authorization in certain situations, including:

• As required by federal, state, or local law

• For public health activities (such as disease prevention or reporting adverse reactions)

• For health oversight activities

• For judicial or administrative proceedings

• To law enforcement officials, as permitted or required by law

• To avert a serious threat to health or safety

• For workers’ compensation or similar programs

Uses and Disclosures Requiring Your Authorization

Any use or disclosure of your PHI for purposes not described in this Notice will be made only with your written authorization. You may revoke your authorization at any time in writing, except to the extent that we have already relied on it.

Your Rights Regarding Your Health Information

You have the right to:

Access and Copies

We do not sell, rent, or trade patient information.

Amendments

Request corrections or amendments to your PHI if you believe it is incorrect or incomplete.

Accounting of Disclosures

Request a list of certain disclosures of your PHI made by the practice.

Restrictions

Request restrictions on certain uses or disclosures of your PHI. We are not required to agree to all requested restrictions.

Confidential Communications

Request that we communicate with you in a specific manner or at a specific location.

Paper Copy of This Notice

Request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.

Our Duties

We are required to:

• Maintain the privacy of your PHI

• Provide you with this Notice of Privacy Practices

• Notify you following a breach of unsecured PHI, if required by law

• Follow the terms of this Notice currently in effect

Changes to This Notice

We reserve the right to change the terms of this Notice. Any changes will apply to all PHI we maintain. The revised Notice will be available upon request and posted on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. You will not be penalized or retaliated against for filing a complaint.

Contact for Privacy Concerns

Privacy Officer: Practice Privacy Officer or Office Manager

(212) 696-5900

35 W 36th Street, Suite 7E, New York, NY 10018

You may also file a complaint with:

U.S. Department of Health and Human Services

Office for Civil Rights

https://www.hhs.gov/ocr/privacy/hipaa/complaints