Provider Demographics
NPI:1417034554
Name:ROBERT C. ALVIS MD PLLC
Entity type:Organization
Organization Name:ROBERT C. ALVIS MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHILES
Authorized Official - Last Name:ALVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-741-5057
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153000207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA63980Medicare UPIN