Clove Lakes Ent Pc in Staten Island - Otolaryngology
Clove Lakes Ent Pc - NPI 1619039815
Clove Lakes Ent Pc is a Otolaryngology in Staten Island, New York. Clove Lakes Ent Pc practices all healthcare services and medical treatments related to Otolaryngology. The NPI Number for Clove Lakes Ent Pc is 1619039815. The last update date is 2021-02-25.
Clove Lakes Ent Pc's current location address is 1414 Victory Blvd, Staten Island, New York. You can contact this provider via phone number 7184471261 and fax number 7189811856. The mailing address for Clove Lakes Ent Pc is 1414 Victory Blvd, Staten Island, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Clove Lakes Ent Pc |
|---|---|
| Address | 1414 Victory Blvd, Staten Island, New York |
| Phone Number | 7184471261 |
| Fax Number | 7189811856 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Kim Hyosun Helen |
| Credentials | MD |
| Telephone Number | 9175967063 |
NPI Number Detail
| NPI Number | 1619039815 |
|---|---|
| Provider Enumeration Date | 2006-12-14 |
| Last Updated Date | 2021-02-25 |
Provider Mailing Address Detail
| Address | 1414 Victory Blvd |
|---|---|
| City | Staten Island |
| State | New York (NY) |
| Post Code | 10301 |
| Phone Number | 7184471261 |
| Fax Number | 7189811856 |
Provider's Primary Taxonomy Detail
| Speciality | Otolaryngology |
|---|---|
| Taxonomy | 207Y00000X |
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Definition: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head an |
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Post Comment/ Review Below
Could you provide the complete physical address where Clove Lakes Ent Pc is located?
The Clove Lakes Ent Pc is situated at the following address: 1414 Victory Blvd, Staten Island, NY, 10301.
Could you kindly provide the complete physical address where Clove Lakes Ent Pc's facilities are geographically located?
The facilities of Clove Lakes Ent Pc are physically situated at the following location: 1414 Victory Blvd, Staten Island, NY, 10301.
What is Clove Lakes Ent Pc's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Clove Lakes Ent Pc is Otolaryngology, and the taxonomy classification code that categorizes this area of expertise is 207Y00000X.
On what date did Clove Lakes Ent Pc receive its 1619039815 assignment from the Centers for Medicare & Medicaid Services?
The Clove Lakes Ent Pc was assigned its 1619039815 on 2006-12-14, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
On what date did the Centers for Medicare & Medicaid Services assign the 1619039815 to Clove Lakes Ent Pc?
The Centers for Medicare & Medicaid Services assigned the 1619039815 to Clove Lakes Ent Pc on 2006-12-14.
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