Provider Demographics
NPI:1518046515
Name:GOTZIS, ANDREW H (MD,PSHYCIATRY)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:H
Last Name:GOTZIS
Suffix:
Gender:M
Credentials:MD,PSHYCIATRY
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Mailing Address - Street 1:250 W 19TH ST
Mailing Address - Street 2:APT 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4034
Mailing Address - Country:US
Mailing Address - Phone:212-627-1623
Mailing Address - Fax:914-793-2159
Practice Address - Street 1:250 W 19TH ST
Practice Address - Street 2:APT 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4034
Practice Address - Country:US
Practice Address - Phone:212-627-1623
Practice Address - Fax:914-793-2159
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1917992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00103976OtherRR MEDICARE
NY74H071Medicare ID - Type Unspecified