Provider Demographics
NPI:1225891856
Name:UNICONN, INC
Entity Type:Organization
Organization Name:UNICONN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOFIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAKHROMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-265-8798
Mailing Address - Street 1:3840 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-1310
Mailing Address - Country:US
Mailing Address - Phone:347-210-3179
Mailing Address - Fax:
Practice Address - Street 1:3840 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1310
Practice Address - Country:US
Practice Address - Phone:347-210-3179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency