Individual
MICHAEL L CENSULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
579A CRANBURY RD, UNIVERSITY RADIOLOGY GROUP, EAST BRUNSWICK, NJ 08816-5426
(732) 390-0040
(732) 390-1856
Mailing address
579A CRANBURY RD, UNIVERSITY RADIOLOGY GROUP PC, EAST BRUNSWICK, NJ 08816-5426
(732) 390-0040
(732) 390-1856
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25MA07567900
NJ
2085R0202X
Diagnostic Radiology Physician
L8643
TX
2085R0204X
Vascular & Interventional Radiology Physician
Primary
25MA07567900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007528
—
NJ
05
—
02957844
—
NY
05
—
166149801
—
TX
01
—
166149802
CSHCN
TX
01
—
8F9479
BCBS
TX
Enumeration date
05/31/2006
Last updated
01/06/2011
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