Provider Demographics
NPI:1114478708
Name:BESPOKE, INC.
Entity Type:Organization
Organization Name:BESPOKE, INC.
Other - Org Name:TOPOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:VARADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-851-5957
Mailing Address - Street 1:255 POTRERO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4814
Mailing Address - Country:US
Mailing Address - Phone:617-851-5957
Mailing Address - Fax:
Practice Address - Street 1:255 POTRERO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4814
Practice Address - Country:US
Practice Address - Phone:617-851-5957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty