Individual
MR. MICHAEL CHARLES SENISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
414 TATUM ST, WOODBURY, NJ 08096-3499
(856) 848-3880
Mailing address
38 PINDALE DR, BRIDGETON, NJ 08302-4901
(856) 455-7979
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00011800
NJ
363A00000X
Physician Assistant
C5-0000539
DE
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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