1972523108 NPI number — GREATER BALTIMORE MEDICAL CENTER, INC.

Table of content: RAAZIA ABID ALI LCSW (NPI 1316521818)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972523108 NPI number — GREATER BALTIMORE MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GREATER BALTIMORE MEDICAL CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972523108
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/05/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 418953
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02241-8953
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6701 N CHARLES ST
Provider Second Line Business Practice Location Address:
SUB ACUTE UNIT 54
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204-6808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-849-2012
Provider Business Practice Location Address Fax Number:
443-849-8056
Provider Enumeration Date:
07/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BEYER
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE VICE PRES & CFO
Authorized Official Telephone Number:
443-849-2519

Provider Taxonomy Codes

  • Taxonomy code: 273Y00000X , with the licence number:  03-072 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 584615-02 . This is a "CAREFIRST OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 745210100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: RL1/0001 . This is a "CAREFIRST REGIONAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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