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General NPI Number Information
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NPI Number | 1629938725
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Entity Type | Organization
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Legal Business Name | BESPOKE PSYCHOLOGY NYC
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 89 5TH AVE STE 903
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City | NEW YORK
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State | NY
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Zip | 10003-3020
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Country | US
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Telephone | 973-346-2446
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Fax |
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Provider Business Mailing Address
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Address Line | 70 REDWOOD DR
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City | ROSLYN
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State | NY
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Zip | 11576-2238
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Country | US
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Telephone | 973-346-2446
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Fax |
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Authorized Official
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Title or Position | FOUNDER & CLINICAL PSYCHOLOGIST
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Name | JENNIFER GITTLEMAN
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Credential | PH.D
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Telephone | 516-712-9440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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