=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447959473
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GOOD HOPE PSYCHIATRY P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2023
-----------------------------------------------------
Last Update Date | 02/28/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 96TH ST
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11209-7520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-495-8777
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 115 96TH ST APT 3B
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11209-7522
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-210-6496
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. PIOTR TOMASZ SLOWIK
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 347-495-8777
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------