Healthcare Provider Details

I. General information

NPI: 1497617112
Provider Name (Legal Business Name): KEYSTONE INTEGRATED HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 OMNI DR
HILLSBOROUGH NJ
08844-4527
US

IV. Provider business mailing address

407 OMNI DR
HILLSBOROUGH NJ
08844-4527
US

V. Phone/Fax

Practice location:
  • Phone: 732-889-5420
  • Fax: 732-931-4593
Mailing address:
  • Phone: 732-889-5420
  • Fax: 732-931-4593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GORDON KUSI
Title or Position: ADVANCED PRACTICE NURSE
Credential: APN, DNP
Phone: 732-889-5420