Provider Demographics
NPI:1437143963
Name:ILVES, RIIVO (MD)
Entity Type:Individual
Prefix:
First Name:RIIVO
Middle Name:
Last Name:ILVES
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SOUTHWOODS BLVD
Mailing Address - Street 2:CAPITAL CARDIOLOGY ASSOCIATES PC DIV OF CARDIO SURGERY
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12211-2526
Mailing Address - Country:US
Mailing Address - Phone:518-292-6000
Mailing Address - Fax:518-641-6766
Practice Address - Street 1:7 SOUTHWOODS BLVD
Practice Address - Street 2:CAPITAL CARDIOLOGY ASSOCIATES PC DIV OF CARDIO SURGERY
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12211-2526
Practice Address - Country:US
Practice Address - Phone:518-292-6000
Practice Address - Fax:518-641-6766
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2008-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY233376208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01373679Medicaid
NYP00156284OtherRR MEDICARE
VT1010085Medicaid
MA2014378Medicaid
NYRA2315Medicare PIN
VT1010085Medicaid