Organization
FACETIME AESTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA COSTA (FOUNDER)
(860) 803-1255
Entity
Organization
Contact information
Practice address
122 SUNNYBROOK DR, MANCHESTER, CT 06040-6660
(860) 803-1255
Mailing address
122 SUNNYBROOK DR, MANCHESTER, CT 06040-6660
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
237361138
DL
CT
Enumeration date
10/06/2022
Last updated
10/06/2022
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