Ethereal Tcm LLC

NPI #1477443273 in Astoria, New York

Provider Information

NPI Number: 1477443273
Entity Type: Organization
Organization Name: Ethereal Tcm LLC
Primary Specialty: Acupuncturist
Enumeration Date: Jul 4, 2025
Last Updated: Jul 4, 2025

Practice Location

Address: 3206 29TH ST APT 4D
City: Astoria
State: New York
ZIP Code: 11106-3464
Phone: (646) 881-3917

Authorized Official

Name: XIN TAO
Title: ACUPUNCTURIST
Phone: (646) 881-3917

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Acupuncturist	171100000X	Primary

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