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Contact Information

SOVEREIGN MEDICAL GROUP LLC
631 GRAND STREET
SUITE 1-1
JERSEY CITY, NJ07304
 Phone: 201-880-7580
 Fax: 201-880-7585
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

NPI Profile & details for SOVEREIGN MEDICAL GROUP LLC

NPI # 1114216660
LBN Legal business name SOVEREIGN MEDICAL GROUP LLC
Authorized official DONALD VARDARO - (ADMINISTRATIVE DIRECTOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 04/06/2011
Last updated 06/09/2011 - About 15 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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