Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Clove Lakes ENT PC

Organization Otolaryngology Physician · NPI 1619039815

Clove Lakes ENT PC is an Otolaryngology Physician in Staten Island, New York. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1414 Victory Blvd
Staten Island, NY 10301
Phone: (718) 447-1261
Fax: (718) 981-1856
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X

Record details

NPI number1619039815
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Helen Kim — Owner · (917) 596-7063
NPI enumeratedDecember 14, 2006
Last updated in NPPESFebruary 25, 2021
Certification dateFebruary 25, 2021
Mailing address1414 Victory Blvd, Staten Island, NY 10301

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