Sovereign Medical Group LLC
Urology in Fair Lawn, New Jersey
1205125655- Practice location
- 15-01 Broadway, Suite 1 & 3, Fair Lawn, NJ 07410
- Phone
- 201-791-4544
- Fax
- 201-794-6970
- Last updated
- May 31, 2018
Sovereign Medical Group LLC is a healthcare organization based in Fair Lawn, NJ. Sovereign Medical Group LLC practices in Fair Lawn, NJ. The NPI Number for Sovereign Medical Group LLC is 1205125655. The current practice location address for Sovereign Medical Group LLC is 15-01 Broadway, Suite 1 & 3, Fair Lawn, NJ 07410 and can be reached out via phone at 201-791-4544 and via fax at 201-794-6970.
Provider Profile Details
- NPI Number
- 1205125655
- Provider Name
- Sovereign Medical Group LLC
- Provider Entity Type
- Organization
- Address
- 15-01 Broadway, Suite 1 & 3, Fair Lawn, NJ 07410
- Phone Number
- 201-791-4544
- Fax Number
- 201-794-6970
- Primary Taxonomy
- Urology · 208800000X
- Organization Subpart
- Yes
- Parent Organization
- Sovereign Medical Group LLC
- Authorized Official
- John H Hajjar, MD · Owner · 201-791-4544
- Other Names
- Urology Specialtly Care PA (Doing Business As)
- Provider Enumeration Date
- April 6, 2011
- Last Update Date
- May 31, 2018
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 15-01 Broadway
Suite 1 & 3
Fair Lawn, NJ 07410 - City
- Fair Lawn
- State
- New Jersey
- Zip
- 07410
- Phone Number
- 201-791-4544
- Fax Number
- 201-794-6970
Provider Business Mailing Address Details
- Address
- 85 Harristown RD Fl 2
Glen Rock, NJ 07452-3329 - City
- Glen Rock
- State
- NJ
- Zip
- 07452-3329
- Phone Number
- 201-855-8446
- Fax Number
- 201-444-0350
License Information
- Taxonomy (1)
- Internal Medicine · 207R00000X
- Taxonomy (2)
- Obstetrics & Gynecology · 207V00000X
- Taxonomy (3)
- Pathology, Clinical Pathology · 207ZC0006X
- Taxonomy (5)
- Radiology, Diagnostic Radiology · 2085R0202X
- Taxonomy (6)
- Urology, Pediatric Urology · 2088P0231X
- Taxonomy (7)
- Urology · 208800000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Urology providers near Fair Lawn, NJ
View all Urology providers in Fair Lawn →Frequently Asked Questions
What is the NPI number of Sovereign Medical Group LLC?
The NPI number of Sovereign Medical Group LLC is 1205125655. It was assigned on April 6, 2011 and is currently active in the NPPES registry.
What is the specialty of Sovereign Medical Group LLC?
Sovereign Medical Group LLC is registered under the primary taxonomy Urology (code 208800000X).
Where does Sovereign Medical Group LLC practice?
The practice location is 15-01 Broadway, Suite 1 & 3, Fair Lawn, NJ 07410. The office can be reached at 201-791-4544 (phone) or 201-794-6970 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1205125655 directly on the NPPES registry website.