Healthcare Provider Details

I. General information

NPI: 1114180882
Provider Name (Legal Business Name): PHILIP CERAULO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MORRIS AVE STE 220
UNION NJ
07083-5675
US

IV. Provider business mailing address

90 MATAWAN RD STE 302
MATAWAN NJ
07747-2653
US

V. Phone/Fax

Practice location:
  • Phone: 732-906-9600
  • Fax: 732-377-0393
Mailing address:
  • Phone: 732-441-7177
  • Fax: 732-441-7165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25MB08316500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number25MB08316500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: