SOVEREIGN MEDICAL GROUP, LLC (NPI# 1184095754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184095754 |
| Entity Type | Organization |
| Organization Name | SOVEREIGN MEDICAL GROUP, LLC |
| Practice Address |
631 Grand St Suite 2-400 Jersey City NJ 07304-3451 |
| Mailing Address |
85 Harristown Rd 2nd Floor Glen Rock NJ 07452-3329 |
| Practice Telephone | 2016366784 |
| Mailing Telephone | 2018558301 |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2015-10-08 |
| Authorized Official Name | DR. JOHN HAJJAR (OWNER) |
| Authorized Official Telephone | 2018558302 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316317787 | Sovereign Medical Group, LLC | Durable Medical Equipment & Medical Supplies | 265 E 33rd St, Paterson, NJ 07504-1668 | 2015-09-29 |
| 1073984654 | Sovereign Medical Group, LLC | Durable Medical Equipment & Medical Supplies | 630 Broad St, Suite 2b, Carlstadt, NJ 07072-1169 | 2015-10-08 |
| 1801266275 | Sovereign Medical Group, LLC | Durable Medical Equipment & Medical Supplies | 85 Harristown Rd, Suite 101, Glen Rock, NJ 07452-3329 | 2015-09-29 |
| Street Address |
631 GRAND ST SUITE 2-400 |
| City | JERSEY CITY |
| State | NJ |
| Zip Code | 07304-3451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619065059 | Alan Marc Shaiman | Radiology | 631 Grand St, Jersey City Radiation Oncology, Jersey City, NJ 07304-3451 | 2006-10-11 |
| 1477988988 | North Eastern Orthopedics | Orthopaedic Surgery | 631 Grand St, Suite 2-400, 2nd Floor, Jersey City, NJ 07304-3451 | 2013-09-04 |
| 1457653834 | Surgicare Surgical Associates of Jersey City, LLC | Clinic/Center | 631 Grand St, Jersey City, NJ 07304-3417 | 2010-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790324085 | Marlon Q Lopez | Physical Therapist | 438 West Avenue, Virginia Cor Ege, Jersey, NJ 07304 | 2020-01-03 |
| 1033621842 | Dipty Mali | Physical Therapist | 520 Bergen Avenue, Jersey City, NJ 07304 | 2017-11-02 |
| 1861914434 | Eulalia Rivera | Licensed Practical Nurse | 140 Boyd Ave, Jersey City, NJ 07304 | 2017-07-14 |
| 1336509223 | Hyojin Park | Student in an Organized Health Care Education/Training Program | 935 Garfield Avenue, Metropolitan Family Health Network, Inc. - Jersey City, Jersey City, NJ 07304 | 2016-03-04 |
| 1962878413 | Hudson Milestones | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13-15 Miller Street, Jersey City, NJ 07304 | 2015-08-19 |
| 1336515881 | Hudson Milestones | Day Training, Developmentally Disabled Services | 355 Clendenny Avenue, Jersey City, NJ 07304 | 2015-08-19 |
| 1922482025 | Cosmo Pharmacy LLC | Pharmacy | 402 Pacific Avenue, Jersey City, NJ 07304 | 2015-07-17 |
| 1033513171 | Walgreens | Health Maintenance Organization | 2395 John Kennedy Blvd, Jersey City, NJ 07304 | 2014-10-17 |
| 1427460138 | Medical Claims Adjustment Pros | Spec/Tech, Health Info | 79 Jewett Avenue Ste 2, Jersey City, NJ 07304 | 2014-05-29 |
| 1801133103 | Hoboken Holistic Physical Therapy and Sports Medicine LLC | Acupuncturist | 701 State Route 440 Suite 21, Jersey City, NJ 07304 | 2013-01-08 |
| Find all providers in zip 07304 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770007601 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1212 Summit Ave, Jersey City, NJ 07307-3137 | 2017-08-02 |
| 1215451042 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2859 61 Kennedy Blvd, Jersey City, NJ 07306 | 2017-08-02 |
| 1770021511 | Riverside Pediatric Group, PC | Durable Medical Equipment & Medical Supplies | 2761 John F Kennedy Blvd, Jersey City, NJ 07306-5515 | 2017-02-01 |
| 1518334440 | Acme Markets Inc | Durable Medical Equipment & Medical Supplies | 321 State Rt 440, Jersey City, NJ 07305 | 2015-08-26 |
| 1346622503 | Vera Oleynik | Durable Medical Equipment & Medical Supplies | 531 W Side Ave, Jersey City, NJ 07304-1517 | 2015-06-24 |
| 1376880112 | Delta Medical/rfg, LLC | Durable Medical Equipment & Medical Supplies | 134 Orient Ave, Jersey City, NJ 07305-3612 | 2013-01-14 |
| 1538421508 | City Pro Group | Durable Medical Equipment & Medical Supplies | 457 Palisade Avenue, Apartment 1, Jersey City, NJ 07307-1521 | 2012-06-14 |
| 1467699074 | Express Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 123 Town Square Pl, 698, Jersey City, NJ 07310-1756 | 2009-01-20 |
| 1255494324 | Shree Yash Corp | Durable Medical Equipment & Medical Supplies | 338 Palisade Ave, Palisade Drugs, Jersey City, NJ 07307-1753 | 2006-12-19 |
| 1124105093 | Umr Pharmacy | Durable Medical Equipment & Medical Supplies | 437 Central Ave, Jersey City, NJ 07307-2729 | 2006-10-31 |
| Find all providers in JERSEY CITY | ||||
| City | JERSEY CITY |
| Zip Code | 07304 |
Please comment or provide details below to improve the information on SOVEREIGN MEDICAL GROUP, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.