SOVEREIGN HEALTH IMAGING LLC NPI 1316997893

NPI Information

NPI: 1316997893
Provider Name: SOVEREIGN HEALTH IMAGING, LLC

Former Legal Business Name: NEW JERSEY INSTITUTE OF RADIOLOGY PC

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
630 BROAD STREET
CARLSTADT, NJ
ZIP 07072
Phone: (201) 372-1020
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SOVEREIGN HEALTH IMAGING, LLC is a diagnostic radiology radiology in Carlstadt, NJ. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. SOVEREIGN HEALTH IMAGING, LLC NPI is 1316997893. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is New Jersey Institute Of Radiology Pc.

The provider's business location address is:

630 BROAD STREET
CARLSTADT, NJ
ZIP 07072-468
Phone: (201) 372-1020
Fax: (201) 372-1028

The provider's authorized official is John H Hajjar .
The authorized official title is Ceo and has the following contact phone number (201) 791-4544.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 6/16/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	207UN0902X	Nuclear Medicine	Nuclear Imaging & Therapy	NEW JERSEY	No
2	207UN0903X	Nuclear Medicine	In Vivo & In Vitro Nuclear Medicine	NEW JERSEY	No
3	2085B0100X	Radiology	Body Imaging	NEW JERSEY	No
4	2085N0700X	Radiology	Neuroradiology	NEW JERSEY	No
5	2085N0904X	Radiology	Nuclear Radiology	NEW JERSEY	No
6	2085P0229X	Radiology	Pediatric Radiology	NEW JERSEY	No
7	2085R0204X	Radiology	Vascular & Interventional Radiology	NEW JERSEY	No
8	2085U0001X	Radiology	Diagnostic Ultrasound	NEW JERSEY	No
9	2085U0001X	Radiology	Diagnostic Ultrasound		No
10	207U00000X	Nuclear Medicine		NEW JERSEY	No
11	207UN0901X	Nuclear Medicine	Nuclear Cardiology	NEW JERSEY	No
12	2085R0202X	Radiology	Diagnostic Radiology	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	475214306	OTHER		TAX ID
2	0133311	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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