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Organization
IRONBOUND MEDICAL SERVICES, LLC
Active
Organization
IRONBOUND MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ANTHONY MUSTILLO MD (OWNER AND MEDICAL DIRECTOR)
(973) 878-3990
Entity
Organization
Contact information
Practice address
221 CHESTNUT ST, NEWARK, NJ 07105-1558
(973) 878-3990
Mailing address
221 CHESTNUT ST, NEWARK, NJ 07105-1558
(973) 878-3990
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
MA053782
NJ
261QU0200X
Urgent Care Clinic/Center
Primary
MA053782
NJ
261QX0100X
Occupational Medicine Clinic/Center
MA053782
NJ
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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