JERSEY CITY RADIATION THERAPY LLC – NPI #1114216660
Radiology

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

JERSEY CITY RADIATION THERAPY LLC is a radiologist located in JERSEY CITY, NJ. NPPES has assigned the NPI number 1114216660 to JERSEY CITY RADIATION THERAPY LLC on April 06, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “JERSEY CITY RADIATION THERAPY LLC” is a dba name, the actual legal business name for this organization is SOVEREIGN MEDICAL GROUP LLC. The primary taxonomy selected by this provider is 2085R0001X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Radiation Oncology

The NPI profile was previously updated about 15 years ago on Jun 09, 2011. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JERSEY CITY RADIATION THERAPY LLC below.

NPI Profile for
SOVEREIGN MEDICAL GROUP LLC

NPI Number
1114216660
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOVEREIGN MEDICAL GROUP LLC
Doing Business As (dba): JERSEY CITY RADIATION THERAPY LLC
Primary location
631 GRAND STREET
SUITE 1-1
JERSEY CITY, NJ 07304
Phone: (201) 880-7580 Fax: (201) 880-7585
Mailing address
Same as primary location
Organization Subpart
Yes - JERSEY CITY RADIATION THERAPY LLC is subpart of another organization.
Authorized Official
DONALD VARDARO
ADMINISTRATIVE DIRECTOR
Phone: (201) 880-7580
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2085R0001X
- Radiology / Radiation Oncology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.