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NPI Code Detail

MEDICARE: PLEASANT VALLEY MEDICAL CARE PLLC

MEDICARE: PLEASANT VALLEY MEDICAL CARE PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RA0000XAdolescent Medicine (Internal Medicine) Physician

General Provider Information

NPI Number : 1306566633
Entity Type Code : Organization
Provider Name (Legal Business Name) : PLEASANT VALLEY MEDICAL CARE PLLC
Provider Business Mailing Address
First Line : 1339 ROUTE 44
Second Line :
City : PLEASANT VALLEY
State : NY
Zip : 12569-7825
Country : US
Telephone Number : 646-943-3906
Fax Number :
Provider Business Practice Location Address
First Line : 1339 ROUTE 44
Second Line :
City : PLEASANT VALLEY
State : NY
Zip : 12569-7825
Country : US
Telephone Number : 646-943-3906
Fax Number :
Authorized Official
Title or Position : MEDICAL DOCTOR
Name : DR. EDMOND KURTOVIC
Credential : MD
Telephone Number : 646-943-3906
Provider Enumeration Date : 08/29/2022
Last Update Date : 01/23/2024

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Directions to “PLEASANT VALLEY MEDICAL CARE PLLC ” Practice Location

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