Provider Demographics
NPI:1295711950
Name:ALVIS, ROBERT CHILES (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHILES
Last Name:ALVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:THORNWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:10594
Mailing Address - Country:US
Mailing Address - Phone:914-741-5057
Mailing Address - Fax:914-741-1169
Practice Address - Street 1:3468 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456
Practice Address - Country:US
Practice Address - Phone:914-741-5057
Practice Address - Fax:914-741-1169
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153000207RN0300X
CT027685207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0004654188OtherAETNA NON HMO
NY00900252Medicaid
NY3C2734OtherHEALTH NET
NY000000077241OtherGHI HMO
NY133884168OtherMULTIPLAN
133884168OtherBEECH STREET
NY133884168OtherHIP
NY2591900OtherGHI PPO
NY8140750OtherCIGNA
NYWS816OtherOXFORD
NY004054OtherCONNECTICARE
NY3375547OtherAETNA HMO
NY132966422OtherUNITED HEALTH CARE
NY133884168OtherPOMCO
NY6X9171OtherBLUE CROSS ALL PLANS
NY133884168OtherEMPIRE STATE PLAN (NYS)
NY132966422OtherUNITED HEALTH CARE
NY133884168OtherMULTIPLAN
NY133884168OtherPOMCO