Provider Demographics
NPI:1649995887
Name:KUSI, CONSTANCE NANA
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:NANA
Last Name:KUSI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 BELMAR BLVD STE I-18
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3984
Mailing Address - Country:US
Mailing Address - Phone:732-743-7666
Mailing Address - Fax:732-743-9455
Practice Address - Street 1:2510 BELMAR BLVD STE I-18
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-3984
Practice Address - Country:US
Practice Address - Phone:732-743-7666
Practice Address - Fax:732-743-9455
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01376700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health