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Individual

DR. ROBERT A MUSTILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

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
202C00000X
Independent Medical Examiner Physician
MA053782
NJ
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
MA053782
NJ
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
MA053782
NJ

Other

Enumeration date
07/23/2007
Last updated
05/21/2008
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