SOVEREIGN MEDICAL GROUP LLC, Diagnostic Radiology CARLSTADT, NJ

Contact Information

SOVEREIGN MEDICAL GROUP LLC

630 BROAD ST
CARLSTADT, NJ 07072-1169

Phone: 201-372-1020
Fax: 201-372-1028
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Diagnostic Radiology	2085R0202X	30	Physician/Diagnostic Radiology
Body Imaging	2085B0100X
Diagnostic Ultrasound	2085U0001X
Neuroradiology	2085N0700X
Nuclear Cardiology	207UN0901X	36	Physician/Nuclear Medicine
Nuclear Imaging & Therapy	207UN0902X	36	Physician/Nuclear Medicine
Pediatric Radiology	2085P0229X
Vascular & Interventional Radiology	2085R0204X	94	Physician/Interventional Radiology

Indicates primary specialty

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NPI Profile & details for SOVEREIGN MEDICAL GROUP LLC · (Female)

NPI Number	`1841589298`
Status	Active
Credentials
Entity	Individual
Enumeration date	04/06/2011
Last updated	06/09/2011 - About 15 years ago
Sole proprietor ¹	Not specified
Identifiers	NJ Medicaid 0133311
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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