Healthcare Provider Details

I. General information

NPI: 1467363374
Provider Name (Legal Business Name): CLEAR SINUS ENT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E 96TH ST APT 19J
NEW YORK NY
10128-3948
US

IV. Provider business mailing address

1 BLUE HILL PLZ STE 1509-24
PEARL RIVER NY
10965-3104
US

V. Phone/Fax

Practice location:
  • Phone: 347-460-2949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW KIM
Title or Position: OWNER
Credential: MD
Phone: 818-307-7280