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DSH330196J CONEY ISLAND HOSPITAL (NYCHHC) (Terminated)
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Main Details
Name
CONEY ISLAND HOSPITAL (NYCHHC)
Subdivision Name
IDA Israel: Pediatrics
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330196J
Medicare Provider Number
330196
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/4/2015
Last Recertification Date
8/19/2021
Termination Date
Termination Reason
10/1/2022
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
NYC Health + Hospitals
Deborah Alyse Brown, Senior Vice President, Chief External Affairs Officer
(347) 947-0446
Primary Contact
New York City Health and Hospitals
Min Than, Assistant Vice President
(212) 442-3854
Addresses
Street Address
2925 West 19th Street
Brooklyn, NY 11224
Billing Address
Coney Island Hospital
2601 Ocean Parkway
Brooklyn, NY 11235
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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