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DSH330214J NYU HOSPITALS CENTER (Terminated)
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Main Details
Name
NYU HOSPITALS CENTER
Subdivision Name
NYU Langone Levit Medical Arts Pavilion - Ambulatory Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330214J
Medicare Provider Number
330214
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/20/2015
Last Recertification Date
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
NYU Langone Health
Daniel J Widawsky, Chief Financial Officer
(212) 263-3092
Primary Contact
Arash Dabestani, Senior Director of Pharmacy
(212) 263-5051
Addresses
Street Address
1616 East 13th Street
Brooklyn, NY 11229
Billing Address
NYU Hospitals Center
550 First Avenue
New York, NY 10016
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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