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General NPI Number Information
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NPI Number | 1487981114
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Entity Type | Individual
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Provider Name | CYNTHIA ELAINE AEBY DOM, LAC
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Gender | Female
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Dates
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Enumeration Date | 11/18/2009
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 2509 VERMONT ST NE STE A2
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4600
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Country | US
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Telephone | 505-266-2606
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Fax |
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Provider Business Mailing Address
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Address Line | 12324 CANDELARIA RD NE APT 2
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-2158
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Country | US
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Telephone | 512-431-2287
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | DOM23001
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC00990
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License Number State | TX
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