Provider Demographics
NPI:1568548329
Name:SINAI HOSPITAL OF BALTIMORE INC
Entity Type:Organization
Organization Name:SINAI HOSPITAL OF BALTIMORE INC
Other - Org Name:LBH MEDICAL GROUP RADIOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:B
Authorized Official - Last Name:EFIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-601-7019
Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-5524
Mailing Address - Fax:410-601-8946
Practice Address - Street 1:2401 W BELVEDERE AVE
Practice Address - Street 2:DEPT. OF RADIOLOGY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5216
Practice Address - Country:US
Practice Address - Phone:410-601-5339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SINAI HOSPITAL OF BALTIMORE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-27
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30-0622085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCC1923OtherR/R MEDICARE GROUP #
MDCC1923OtherR/R MEDICARE GROUP #