Organization
SOVEREIGN MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN HAJJAR M.D. (OWNER)
(201) 855-8302
Entity
Organization
Contact information
Practice address
630 BROAD ST, SUITE 2B, CARLSTADT, NJ 07072-1169
(201) 355-1700
Mailing address
85 HARRISTOWN RD, 2ND FLOOR, GLEN ROCK, NJ 07452-3329
(201) 855-8301
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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