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DSH330119S LENOX HILL HOSPITAL (Active)
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Main Details
Name
LENOX HILL HOSPITAL
Subdivision Name
Outpatient Center for Mental Health - Mental Health
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330119S
Medicare Provider Number
330119
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/7/2022
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
20 E 64th St
New York, NY 10065
Billing Address
Lenox Hill Hospital
100 E 77th St
New York, NY 10075
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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