Organization · Type 2 NPI

Sovereign Medical Group LLC

Radiation Oncology Physician · Jersey City, NJ

NPI number 1114216660 Active

Practice location

631 Grand Street, Suite 1-1
Jersey City, NJ 07304

Fax (201) 880-7585

Specialties and licenses

Taxonomy	Code	License
Radiation Oncology Physician Primary	2085R0001X	None listed

Radiation Oncology Physician: A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

2 other providers at this address

Jersey City Radiation Therapy LLCRadiation Oncology Physician Jersey City, NJ NPI 1902104573
Urology Specialty Care PARadiation Oncology Physician Jersey City, NJ NPI 1871885814

Other radiation oncology physician providers in Jersey City

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NPI record

NPI: 1114216660
Entity type: Organization (Type 2)
Issued: Apr 6, 2011
Last updated: Jun 9, 2011
Status: Active
Subpart: Yes of Sovereign Medical Group LLC

Other names

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Jersey City Radiation Therapy LLC · doing business as

Authorized official

Donald Vardaro
Administrative Director
(201) 880-7580

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1114216660

Sovereign Medical Group LLC's National Provider Identifier is 1114216660, issued on Apr 6, 2011. The primary taxonomy on file is Radiation Oncology Physician (2085R0001X), and the practice location is in Jersey City, NJ. The record was last updated on Jun 9, 2011.