Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sovereign Medical Group LLC

Organization Internal Medicine Physician · NPI 1205125655

Sovereign Medical Group LLC is an Internal Medicine Physician in Fair Lawn, New Jersey. Works from 2 locations. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
7
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

15-01 Broadway Ste 1 & 3
Fair Lawn, NJ 07410
Phone: (201) 791-4544
Fax: (201) 794-6970
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 15-01 Broadway, Fair Lawn, NJ 07410-6003 — (201) 791-4544

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X
Internal Medicine Physician Taxonomy 207R00000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Clinical Pathology Physician Taxonomy 207ZC0006X
Radiation Oncology Physician Taxonomy 2085R0001X
Diagnostic Radiology Physician Taxonomy 2085R0202X
Pediatric Urology Physician Taxonomy 2088P0231X

Record details

NPI number1205125655
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSovereign Medical Group LLC
Authorized official John Hajjar — Owner · (201) 791-4544
Other names Urology Specialtly Care Pa; Urology Specialtly Care Pa
NPI enumeratedApril 6, 2011
Last updated in NPPESMay 31, 2018
Mailing address85 Harristown Rd Fl 2, Glen Rock, NJ 07452-3329

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