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PLEASANT VALLEY PEDIATRIC MEDICINE, PLLC
NPI 1639954464
Clinic/Center - Primary Care in Pleasant Valley, NY

Active since August 29, 2023CLIA 33D2289633 · Waiver
1539 MAIN ST, UNIT D, #192, PLEASANT VALLEY, NY 12569(845) 723-4499(845) 723-4196 Get Directions Write a Review

NPPES record last updated: December 11, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 11, 2023, Nov 14, 2023, Oct 3, 2023 and 1 more (4 updates tracked since 2023).

About Pleasant Valley Pediatric Medicine, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PLEASANT VALLEY PEDIATRIC MEDICINE, PLLC (NPI 1639954464) is a healthcare organization registered as a primary care in Pleasant Valley, New York and active in the NPI registry since August 2023. The organization holds a CLIA Waiver certificate valid through September 12, 2027 and lists Jack Jeffrey Sobrin, Owner, as its authorized official.

NPPES Registry Identity

NPI1639954464
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePLEASANT VALLEY PEDIATRIC MEDICINE, PLLC
Location Address1539 MAIN ST, UNIT D, #192Pleasant Valley, NY 12569-0192
Mailing AddressPo Box 192Pleasant Valley, NY 12569-0192 · (845) 723-4499 · Fax (845) 723-4196
Phone(845) 723-4499
Fax(845) 723-4196
Organization SubpartNo
Authorized OfficialJack Jeffrey SobrinOwner · (845) 723-4499
Enumeration DateAugust 29, 2023
Last NPPES UpdateDecember 11, 20234 updates tracked since enumeration
NPPES CertifiedDecember 11, 2023
✔ NPI 1639954464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1539 MAIN ST, UNIT D, Pleasant Valley, NY 12569
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2289633

Pleasant Valley Pediatric Medicine PLLC · Pleasant Valley, NY
Active · expires Sep 12, 2027
CLIA Number33D2289633
Laboratory TypePhysician Office
Certificate Effective DateSeptember 13, 2025
Certificate Expiration DateSeptember 12, 2027
Laboratory DirectorDr. Jack J. Sobrin
Laboratory Phone(845) 723-4499
Laboratory LocationPleasant Valley Pediatric Medicine PLLC1539 Main St, Suite D, Pleasant Valley, NY 12569
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

What is PLEASANT VALLEY PEDIATRIC MEDICINE, PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1639954464, enumerated as an "organization" on August 29, 2023.

Where is the provider located?

The provider is located at 1539 MAIN ST, UNIT D #192 PLEASANT VALLEY, NY 12569 and the phone number is (845) 723-4499.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.