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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