Healthcare Provider Details

I. General information

NPI: 1326866716
Provider Name (Legal Business Name): PERCY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 JUNIPER TER
TUXEDO PARK NY
10987-4770
US

IV. Provider business mailing address

71 JUNIPER TER
TUXEDO PARK NY
10987-4770
US

V. Phone/Fax

Practice location:
  • Phone: 201-669-0619
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ALYSSA HORNEFF
Title or Position: CO-FOUNDER & CEO
Credential:
Phone: 201-669-0610