Healthcare Provider Details

I. General information

NPI: 1134964315
Provider Name (Legal Business Name): SINAI HOSPITAL OF BALTIMORE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 RIDGEVILLE BLVD
MT. AIRY MD
21771-5942
US

IV. Provider business mailing address

504 RIDGEVILLE BLVD
MT. AIRY MD
21771-5942
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-8663
  • Fax: 410-604-5389
Mailing address:
  • Phone: 410-601-8663
  • Fax: 410-604-5389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number
License Number State

VIII. Authorized Official

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