=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588485692
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MORE THAN PERFECT HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/21/2024
-----------------------------------------------------
Last Update Date | 10/21/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 55 THOMPSON ST APT 3A
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10012-0286
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-400-6323
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 55 THOMPSON ST APT 3A
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10012-0286
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-400-6323
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRINCIPAL
-----------------------------------------------------
Name | LAUREN ALLEGRA WEILL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 917-400-6323
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174200000X
-----------------------------------------------------
Taxonomy Name | Meals Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------