Provider Demographics
NPI:1114765526
Name:UNIQUEONE A. ENTERPRISE, LLC
Entity type:Organization
Organization Name:UNIQUEONE A. ENTERPRISE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UNIKA
Authorized Official - Middle Name:ALECIA
Authorized Official - Last Name:WILLIAMS-CRISPIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMY
Authorized Official - Phone:929-625-6578
Mailing Address - Street 1:1305 MIDDLE COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-2554
Mailing Address - Country:US
Mailing Address - Phone:929-625-6578
Mailing Address - Fax:855-719-2566
Practice Address - Street 1:1305 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-2554
Practice Address - Country:US
Practice Address - Phone:929-625-6578
Practice Address - Fax:855-719-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty