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  5. STATEN ISLAND UNIVERSITY HOSPITAL

STATEN ISLAND UNIVERSITY HOSPITAL

Company Details

Name: STATEN ISLAND UNIVERSITY HOSPITAL
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 16 Jun 1987 (38 years ago)
Entity Number: 1179657
ZIP code: 10305
County: Richmond
Place of Formation: New York
Address: ATTN ADMINISTRATION, 475 SEAVIEW AVENUE, STATEN ISLAND, NY, United States, 10305

Contact Details

Phone +1 718-226-4549

Phone +1 718-226-9000

Phone +1 718-226-1914

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
UHVMZK1C4A31 2024-05-11 475 SEAVIEW AVE, STATEN ISLAND, NY, 10305, 3436, USA 475 SEAVIEW AVENUE, STATEN ISLAND, NY, 10305, 3436, USA

Business Information
Division Name STATEN ISLAND UNIVERSITY HOSPITAL
Congressional District 11
State/Country of Incorporation NY, USA
Activation Date 2023-05-16
Initial Registration Date 2005-12-28
Entity Start Date 1861-01-01
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 622110
Product and Service Codes Q999

Points of Contacts
Electronic Business
Title PRIMARY POC
Name DIANE MARBURY
Role SENIOR DIRECTOR, GRANTS MANAGEMENT
Address 350 COMMUNITY DRIVE, GRANTS MANAGEMENT OFFICE, MANHASSET, NY, 11030, USA
Title ALTERNATE POC
Name ANGELICA C GOMEZ
Address ONE EDGEWATER PLAZA, STATEN ISLAND, NY, 10305, 4900, USA
Government Business
Title PRIMARY POC
Name DIANE MARBURY
Role SENIOR DIRECTOR, GRANTS MANAGEMENT
Address 350 COMMUNITY DRIVE, GRANTS MANAGEMENT OFFICE, MANHASSET, NY, 11030, USA
Title ALTERNATE POC
Name DIANE QUINN
Role AVP, FINANCE OPERATIONS
Address 350 COMMUNITY DRIVE, GRANTS MANAGEMENT OFFICE, MANHASSET, NY, 11030, 3436, USA
Past Performance Information not Available

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
48XM8 Active Non-Manufacturer 2005-12-29 2024-05-23 2029-05-23 2025-05-13

Contact Information
POC DIANE MARBURY
Phone +1 516-465-2664
Address 475 SEAVIEW AVE, STATEN ISLAND, NY, 10305 3436, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner
Vendor Certified 2024-05-15
CAGE number 4AJP5
Company Name NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC.
CAGE Last Updated 2024-03-03
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DOCTOR'S HOSPITAL OF STATEN ISLAND RETIREMENT PLAN AND TRUST AGREEMENT 2009 112868878 2011-06-09 STATEN ISLAND UNIVERSITY HOSPITAL 291
Three-digit plan number (PN) 001
Effective date of plan 1975-09-01
Business code 622000
Sponsor’s telephone number 7182261992
Plan sponsor’s mailing address 475 SEAVIEW AVENUE, STATEN ISLAND, NY, 103050000
Plan sponsor’s address 475 SEAVIEW AVENUE, STATEN ISLAND, NY, 103050000

Plan administrator’s name and address
Administrator’s EIN 133159766
Plan administrator’s name STATEN ISLAND UNIVERSITY HOSPITAL
Plan administrator’s address 475 SEAVIEW AVENUE, STATEN ISLAND, NY, 103050000
Administrator’s telephone number 7182261992

Number of participants as of the end of the plan year
Active participants 43
Retired or separated participants receiving benefits 133
Other retired or separated participants entitled to future benefits 108
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 9

Signature of
Role Plan administrator
Date 2011-06-09
Name of individual signing DEBRA SANTANGELO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-06-09
Name of individual signing DEBRA SANTANGELO
Valid signature Filed with authorized/valid electronic signature
DOCTOR'S HOSPITAL OF STATEN ISLAND RETIREMENT PLAN AND TRUST AGREEMENT 2009 112868878 2011-06-13 STATEN ISLAND UNIVERSITY HOSPITAL 291
Three-digit plan number (PN) 001
Effective date of plan 1975-09-01
Business code 622000
Sponsor’s telephone number 7182261992
Plan sponsor’s mailing address 475 SEAVIEW AVENUE, STATEN ISLAND, NY, 103050000
Plan sponsor’s address 475 SEAVIEW AVENUE, STATEN ISLAND, NY, 103050000

Plan administrator’s name and address
Administrator’s EIN 133159766
Plan administrator’s name STATEN ISLAND UNIVERSITY HOSPITAL
Plan administrator’s address 475 SEAVIEW AVENUE, STATEN ISLAND, NY, 103050000
Administrator’s telephone number 7182261992

Number of participants as of the end of the plan year
Active participants 43
Retired or separated participants receiving benefits 133
Other retired or separated participants entitled to future benefits 108
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 9

Signature of
Role Plan administrator
Date 2011-06-09
Name of individual signing DEBRA SANTANGELO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-06-09
Name of individual signing DEBRA SANTANGELO
Valid signature Filed with authorized/valid electronic signature
DOCTOR'S HOSPITAL OF STATEN ISLAND RETIREMENT PLAN AND TRUST AGREEMENT 2009 112868878 2011-06-14 STATEN ISLAND UNIVERSITY HOSPITAL 291
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-09-01
Business code 622000
Sponsor’s telephone number 7182261992
Plan sponsor’s mailing address 475 SEAVIEW AVENUE, STATEN ISLAND, NY, 103050000
Plan sponsor’s address 475 SEAVIEW AVENUE, STATEN ISLAND, NY, 103050000

Plan administrator’s name and address
Administrator’s EIN 133159766
Plan administrator’s name STATEN ISLAND UNIVERSITY HOSPITAL
Plan administrator’s address 475 SEAVIEW AVENUE, STATEN ISLAND, NY, 103050000
Administrator’s telephone number 7182261992

Number of participants as of the end of the plan year
Active participants 43
Retired or separated participants receiving benefits 133
Other retired or separated participants entitled to future benefits 108
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 9

Signature of
Role Plan administrator
Date 2011-06-09
Name of individual signing DEBRA SANTANGELO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-06-09
Name of individual signing DEBRA SANTANGELO
Valid signature Filed with authorized/valid electronic signature
STATEN ISLAND UNIVERSITY HOSPITAL BENEFITS PLAN 2009 112868878 2010-10-14 STATEN ISLAND UNIVERSITY HOSPITAL 1460
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1989-01-01
Business code 622000
Sponsor’s telephone number 7182268676
Plan sponsor’s mailing address 500 SEAVIEW AVENUE, STATEN ISLAND, NY, 10305
Plan sponsor’s address 500 SEAVIEW AVENUE, STATEN ISLAND, NY, 10305

Plan administrator’s name and address
Administrator’s EIN 112868878
Plan administrator’s name STATEN ISLAND UNIVERSITY HOSPITAL
Plan administrator’s address 500 SEAVIEW AVENUE, STATEN ISLAND, NY, 10305
Administrator’s telephone number 7182268676

Number of participants as of the end of the plan year
Active participants 7078

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing DEBRA SANTANGELO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-14
Name of individual signing DEBRA SANTANGELO
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent ATTN ADMINISTRATION, 475 SEAVIEW AVENUE, STATEN ISLAND, NY, United States, 10305

History

Start date End date Type Value
2011-09-23 2018-04-17 Address ATTN: OFFICE OF LEGAL AFFAIRS, 145 COMMUNITY DRIVE, GREAT NECK, NY, 11021, USA (Type of address: Service of Process)
2005-03-03 2011-09-23 Address OFFICE OF VICE PRESIDENT AND, GENERAL COUNSEL 475 SEAVIEW AV, STATEN ISLAND, NY, 10305, USA (Type of address: Service of Process)
2001-02-28 2005-03-03 Address 111 GREAT NECK ROAD, GREAT NECK, NY, 11021, USA (Type of address: Service of Process)
2000-10-05 2001-02-28 Address 111 GREAT NECK ROAD, GREAT NECK, NY, 11021, USA (Type of address: Service of Process)
1992-01-17 2000-10-05 Address 175 GREAT NECK ROAD, GREAT NECK, NY, 11021, USA (Type of address: Service of Process)
1989-12-01 1992-01-17 Address STATEN ISLAND UNIV. HOSP, 175 GREAT NECK RD., GREAT NECK, NY, 11021, USA (Type of address: Service of Process)
1987-06-16 1989-12-01 Address 175 GREAT NECK RD, ATTN: CHS, GREAT NECK, NY, 11021, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
180417000177 2018-04-17 CERTIFICATE OF AMENDMENT 2018-04-17
110923000760 2011-09-23 CERTIFICATE OF AMENDMENT 2011-09-23
050303001117 2005-03-03 CERTIFICATE OF CHANGE 2005-03-03
010228000937 2001-02-28 CERTIFICATE OF AMENDMENT 2001-02-28
001005000309 2000-10-05 CERTIFICATE OF CHANGE 2000-10-05
920117000425 1992-01-17 CERTIFICATE OF AMENDMENT 1992-01-17
900924000387 1990-09-24 CERTIFICATE OF CORRECTION 1990-09-24
C081646-8 1989-12-01 CERTIFICATE OF AMENDMENT 1989-12-01
C037964-7 1989-07-27 CERTIFICATE OF AMENDMENT 1989-07-27
B509835-39 1987-06-16 CERTIFICATE OF CONSOLIDATION 1987-06-16

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Related by address

No related companies by address

Date of last update: 23 Jan 2025

Sources: New York Secretary of State

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