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DSH330119A LENOX HILL HOSPITAL (Active)
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Main Details
Name
LENOX HILL HOSPITAL
Subdivision Name
Manhattan Eye, Ear, & Throat Hospital - Mental Health Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330119A
Medicare Provider Number
330119
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/12/2022
Participating Start Date
1/24/2022
Participating Approval Date
1/12/2022
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Northwell Health
Michele L Cusack, Executive Vice President
(516) 321-6058
Primary Contact
Northwell
Onisis Stefas, VP of Pharmacy Operations
(516) 719-5720
Addresses
Street Address
210 E 64th St
New York, NY 10065
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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