Organization
SOVEREIGN HEALTH IMAGING, LLC
Active
Other names
New Jersey Institute of Radiology PC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN H HAJJAR MD (CEO)
(201) 791-4544
Entity
Organization
Contact information
Practice address
630 BROAD STREET, CARLSTADT, NJ 07072-0468
(201) 372-1020
(201) 372-1028
Mailing address
630 BROAD STREET, CARLSTADT, NJ 07072-0468
(201) 372-1020
(201) 372-1028
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
—
NJ
207UN0901X
Nuclear Cardiology Physician
—
NJ
207UN0902X
Nuclear Imaging & Therapy Physician
—
NJ
207UN0903X
In Vivo & In Vitro Nuclear Medicine Physician
—
NJ
2085B0100X
Body Imaging Physician
—
NJ
2085N0700X
Neuroradiology Physician
—
NJ
2085N0904X
Nuclear Radiology Physician
—
NJ
2085P0229X
Pediatric Radiology Physician
—
NJ
2085R0202X
Diagnostic Radiology Physician
Primary
—
NJ
2085R0204X
Vascular & Interventional Radiology Physician
—
NJ
2085U0001X
Diagnostic Ultrasound Physician
—
NJ
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133311
—
NJ
01
—
475214306
TAX ID
—
Enumeration date
05/12/2006
Last updated
06/16/2018
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