# LIFEBRIDGE COMMUNITY PHYSICIANS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LifeBridge Health ENT, Sinus & Allergy Center at Old Court
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811706559
- **Authorized official:** MARY REBECCA WRIGHT-SISK (DIRECTOR)
- **Authorized official phone:** (443) 623-8926

## Contact information

- **Practice address:** 5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
- **Practice address phone:** (443) 289-3459
- **Practice address fax:** (443) 289-3488
- **Mailing address:** 5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
- **Mailing address phone:** (443) 289-3459
- **Mailing address fax:** (443) 289-3488

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NULL | Yes |
| 207Y00000X | Otolaryngology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/07/2025
- **Last updated:** 01/07/2025