Healthcare Provider Details

I. General information

NPI: 1073436127
Provider Name (Legal Business Name): GARDELLA PSYCHOLOGICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 SCENIC DR
HYDE PARK NY
12538-1324
US

IV. Provider business mailing address

3979 ALBANY POST RD STE 2 UNIT 2337
HYDE PARK NY
12538-1968
US

V. Phone/Fax

Practice location:
  • Phone: 201-925-5561
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMIE GARDELLA
Title or Position: OWNER
Credential: PH.D.
Phone: 201-925-5561