Provider Demographics
NPI:1871736603
Name:NICOLE UNSER INC.
Entity type:Organization
Organization Name:NICOLE UNSER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:UNSER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:518-469-2460
Mailing Address - Street 1:95 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:AVERILL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12018-3725
Mailing Address - Country:US
Mailing Address - Phone:518-931-4095
Mailing Address - Fax:
Practice Address - Street 1:95 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:AVERILL PARK
Practice Address - State:NY
Practice Address - Zip Code:12018-3725
Practice Address - Country:US
Practice Address - Phone:518-931-4095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4559041251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care