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General NPI Number Information
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NPI Number | 1356115919
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Entity Type | Organization
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Legal Business Name | A GENTLE TOUCH ELECTROLYSIS LLC
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Dates
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Enumeration Date | 11/14/2023
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 369 NEW BRITAIN RD STE C
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City | BERLIN
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State | CT
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Zip | 06037-1351
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Country | US
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Telephone | 860-543-0618
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Fax |
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Provider Business Mailing Address
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Address Line | 17 MEADOW LN
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City | BERLIN
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State | CT
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Zip | 06037-3601
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Country | US
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Telephone | 860-543-0618
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER VAUGHAN-PIGNATELLA
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Credential | CPE
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Telephone | 860-543-0618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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