National Provider Identifier Database

SOVEREIGN MEDICAL GROUP LLC
Diagnostic Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.


Contact Information

SOVEREIGN MEDICAL GROUP LLC
630 BROAD ST
CARLSTADT, NJ07072-1169
Phone: 201-372-1020
Fax: 201-372-1028
Website:
Specialty Taxonomy Code
* Diagnostic Radiology 2085R0202X
Body Imaging 2085B0100X
Diagnostic Ultrasound 2085U0001X
Neuroradiology 2085N0700X
Nuclear Cardiology 207UN0901X
Nuclear Imaging & Therapy 207UN0902X
Pediatric Radiology 2085P0229X
Vascular & Interventional Radiology 2085R0204X

* Indicates primary specialty

NPI Profile & details for SOVEREIGN MEDICAL GROUP LLC

NPI Number 1841589298
Legal business name
LBN
SOVEREIGN MEDICAL GROUP LLC
Authorized official JOHN HAJJAR - (CEO)
Entity Organization
Organization subpart Yes
Enumeration date 04/06/2011
Last updated 06/09/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • NJ Medicaid: 0133311

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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