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General NPI Number Information
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NPI Number | 1619568227
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Entity Type | Organization
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Legal Business Name | IRONBOUND COMMUNITY HEALTH CENTER INC
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | 788 MOUNT PROSPECT AVE FL 2
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City | NEWARK
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State | NJ
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Zip | 07104-3221
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Country | US
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Telephone | 973-433-9773
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Fax |
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Provider Business Mailing Address
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Address Line | 788 MOUNT PROSPECT AVE FL 2
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City | NEWARK
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State | NJ
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Zip | 07104-3221
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Country | US
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Telephone | 973-433-9773
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. NURIS RODRIGUEZ-PABON
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Credential | LCSW
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Telephone | 973-433-9773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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