Pleasant Valley Pediatric Medicine, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PLEASANT VALLEY PEDIATRIC MEDICINE, PLLC

Practice address

1539 Main St, Unit D
#192
Pleasant Valley, NY 12569-0192

Phone

(845) 723-4499

Fax

(845) 723-4196

NPI assigned

Aug 29, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jack Jeffrey Sobrin, DONPI 1588662241

Title

Owner

Phone

(845) 723-4499

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jack J Sobrin, D.O.

  • Pediatrics Physician
  • Pleasant Valley, NY
  • NPI 1588662241
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1639954464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192",
            "city": "PLEASANT VALLEY",
            "state": "NY",
            "postal_code": "125690192",
            "telephone_number": "845-723-4499",
            "fax_number": "845-723-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 MAIN ST, UNIT D",
            "address_2": "#192",
            "city": "PLEASANT VALLEY",
            "state": "NY",
            "postal_code": "125690192",
            "telephone_number": "845-723-4499",
            "fax_number": "845-723-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT VALLEY PEDIATRIC MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "SOBRIN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-723-4499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Playmore Therapies LLC
• Pleasant Valley Chemists Inc
• Pleasant Valley Chemists Inc
• Pleasant Valley Medical Care PLLC
• Pleasant Valley Mental Health Counseling, PLLC
• Lujayn Najib Musa Rabadi
• Phyllis Elaine Randall, PA
• Lynne G. Raskin, MS,MA,SLP
• Carolyn Razak
• Reilly RPH, LLC

• Primary Care Clinic/Center in Pleasant Valley, NY
• Providers in Pleasant Valley, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.