Provider Demographics
NPI:1306566633
Name:PLEASANT VALLEY MEDICAL CARE PLLC
Entity type:Organization
Organization Name:PLEASANT VALLEY MEDICAL CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-943-3906
Mailing Address - Street 1:1339 ROUTE 44
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12569-7825
Mailing Address - Country:US
Mailing Address - Phone:646-943-3906
Mailing Address - Fax:
Practice Address - Street 1:1339 ROUTE 44
Practice Address - Street 2:
Practice Address - City:PLEASANT VALLEY
Practice Address - State:NY
Practice Address - Zip Code:12569-7825
Practice Address - Country:US
Practice Address - Phone:646-943-3906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Single Specialty