Healthcare Provider Details

I. General information

NPI: 1194834036
Provider Name (Legal Business Name): SINAI HOSPITAL OF BALTIMORE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 FAIRMOUNT AVE
BALTIMORE MD
21286-5466
US

IV. Provider business mailing address

515 FAIRMOUNT AVE
BALTIMORE MD
21286-5466
US

V. Phone/Fax

Practice location:
  • Phone: 410-581-3985
  • Fax: 410-494-1361
Mailing address:
  • Phone: 410-581-3985
  • Fax: 410-494-1361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE BEASLEY-THOMAS
Title or Position: DIRECTOR OF REIMBUSEMENT
Credential:
Phone: 410-494-1212