340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH330160AU STATEN ISLAND UNIVERSITY HOSPITAL (Active)
Print
Main Details
Name
STATEN ISLAND UNIVERSITY HOSPITAL
Subdivision Name
Medical Arts Pavilion - Geriatrics - Geriatrics
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330160AU
Medicare Provider Number
330160
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/6/2022
Participating Start Date
1/1/2023
Participating Approval Date
10/19/2022
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
242 Mason Avenue
SUITE 2
Staten Island, NY 10305
Billing Address
Staten Island University Hospital
475 Seaview Avenue
Staten Island, NY 10305
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session