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Organization

CLOVE LAKES ENT PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HELEN HYOSUN KIM MD (OWNER)
(917) 596-7063
Entity
Organization

Contact information

Practice address
1414 VICTORY BLVD, STATEN ISLAND, NY 10301
(718) 447-1261
(718) 981-1856
Mailing address
1414 VICTORY BLVD, STATEN ISLAND, NY 10301
(718) 447-1261
(718) 981-1856

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary

Other

Enumeration date
12/14/2006
Last updated
02/25/2021
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