Individual
MRS. KUSUM L KANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,CDE
Contact information
Practice address
332 LAFAYETTE AVE, HAWTHORNE, NJ 07506-2506
(973) 460-7560
(862) 239-6059
Mailing address
28 AGAWAM DR, WAYNE, NJ 07470-2060
(973) 460-7560
(973) 696-3532
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
586681
NJ
Other
Enumeration date
06/20/2005
Last updated
04/27/2017
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