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Organization
GODBRIDGE INTERGRATED CARE
Active
Organization
GODBRIDGE INTERGRATED CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON KUSI APN (ADVANCED PRACTISE NURSE)
(973) 489-7101
Entity
Organization
Contact information
Practice address
6 WYCKOFF PL, FRANKLIN PARK, NJ 08823-1816
(973) 489-7101
Mailing address
6 WYCKOFF PL, FRANKLIN PARK, NJ 08823-1816
(973) 489-7101
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
103TC1900X
Counseling Psychologist
—
NULL
103TC1900X
Counseling Psychologist
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/19/2020
Last updated
01/19/2020
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