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DSH330196D CONEY ISLAND HOSPITAL (Terminated)
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Main Details
Name
CONEY ISLAND HOSPITAL
Subdivision Name
Mobile Medical Office Van #2 / Podiatry and Ophthalmology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330196D
Medicare Provider Number
330196
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/30/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/12/2014
Last Recertification Date
8/15/2016
Termination Date
Termination Reason
1/1/2018
Site closure
Contacts
Authorizing Official
New York City Health and Hospitals
Paul Albertson, Vice President
(212) 748-2256
Primary Contact
New York City Health + Hospitals
Danielle Sestito, Senior Director, 340B Operations
(212) 442-3892
Addresses
Street Address
460 Brielle Ave
Staten Island, NY 10314
Billing Address
Coney Island Hospital
2601 Ocean Parkway
Brooklyn, NY 11235
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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