Organization Active NPI

Bespoke Therapy & Care

  • Hearing and Speech Clinic/Center
  • Montclair, NJ
National Provider Identifier
1174359509
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
Legal business name
BESPOKE THERAPY & CARE
Practice address
109 Valley Rd
Montclair, NJ 07042-2322
Phone
(215) 439-2205
NPI assigned
Sep 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Isra Shilad, CCC-SLP
Title
Manager
Phone
(215) 439-2205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X Primary

Addresses

Primary practice location

109 Valley Rd
Montclair, NJ 07042-2322

Mailing address

109 Valley Rd
Montclair, NJ 07042-2322

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1174359509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 VALLEY RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 VALLEY RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422322",
            "telephone_number": "215-439-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BESPOKE THERAPY & CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "SHILAD",
        "authorized_official_first_name": "ISRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-439-2205",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.