Healthcare Provider Details

I. General information

NPI: 1467477075
Provider Name (Legal Business Name): SINAI HOSPITAL OF BALTIMORE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BELVEDERE AVENUE LAPIDUS CANCER INSTITUTE
BALTIMORE MD
21215
US

IV. Provider business mailing address

2401 W BELVEDERE AVE ATTN: CREDENTIALING
BALTIMORE MD
21215-5216
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-4710
  • Fax: 410-601-8448
Mailing address:
  • Phone: 410-601-5524
  • Fax: 410-601-8946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number30-062
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number30-062
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number30-062
License Number StateMD

VIII. Authorized Official

Name: MR. CHARLES B EFIRD
Title or Position: DIRECTOR
Credential:
Phone: 410-601-7019