Provider Demographics
NPI:1811979438
Name:REEVES, ROBERT PETER JR (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PETER
Last Name:REEVES
Suffix:JR
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 1:3 IRONGATE CENTER
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3471
Mailing Address - Country:US
Mailing Address - Phone:518-793-4409
Mailing Address - Fax:518-793-5886
Practice Address - Street 1:3 IRONGATE CENTER
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3471
Practice Address - Country:US
Practice Address - Phone:518-793-4409
Practice Address - Fax:518-793-5886
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198141207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY021200700210OtherFIDELIS
NY10001697OtherCDPHP
NY10499999OtherCAQH
NY01635107Medicaid
NY08631OtherMVP
NY5030234OtherAETNA
NY000401507001OtherBLUE SHIELD NENY
NY000000042628OtherGHI-HMO
NY00020847201OtherUNIVERA
NY410971OtherBLUE CROSS BLUE SHIELD
NYCD1981OtherRAILROAD MEDICARE GROUP #
NY00020847201OtherUNIVERA
NY10001697OtherCDPHP