Provider Demographics
NPI:1194834036
Name:SINAI HOSPITAL OF BALTIMORE, INC.
Entity Type:Organization
Organization Name:SINAI HOSPITAL OF BALTIMORE, INC.
Other - Org Name:SINAI CLINICAL PROFESSIONAL D/B/A CLINICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBUSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEASLEY-THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-494-1212
Mailing Address - Street 1:515 FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5466
Mailing Address - Country:US
Mailing Address - Phone:410-581-3985
Mailing Address - Fax:410-494-1361
Practice Address - Street 1:515 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21286-5466
Practice Address - Country:US
Practice Address - Phone:410-581-3985
Practice Address - Fax:410-494-1361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD988271500Medicaid
MD0429910001Medicare PIN
MD057SMedicare PIN
MD988271500Medicaid
MD109MMedicare PIN
MDH596Medicare PIN
MD157676Medicare PIN