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Subject Number 046-1109 Newly Authorized Health Care Providers Approved to Render Services to Injured Workers Under the Workers' Compensation Law

Subject Numbers Regarding Health Provider Authorizations

October 4, 2018

The following have been added to the list of providers authorized to treat injured workers and/or perform independent medical examinations within the New York State workers’ compensation system.

NAME SPECIALTY AREA OF PRACTICE CITY OF PRACTICE AUTHORIZATION NUMBER* EFFECTIVE DATE
Baik, Michael Hyun Anesthesiology Rochester 274479-5W September 20, 2018
Barouch, Andrea Fae Anesthesiology Suffern 252566-5W September 18, 2018
Bellaousov, Katsiaryna Anesthesiology Rochester 281013-3W September 24, 2018
Chiao, Franklin Anesthesiology Mount Kisco 254449-2B September 25, 2018
Correll, Lynn Rudner Anesthesiology Rochester 273300-4W September 24, 2018
Dave, Anjalee Anesthesiology New York 234182-4W September 18, 2018
Ferreras, Krystal Marie Anesthesiology New Hyde Park 291440-6W September 12, 2018
Kianpour, Daniel Nasser Anesthesiology Rochester 293157-4W September 24, 2018
Kime, Courtney Kristine Anesthesiology Rochester 295043-4W September 20, 2018
Kirzner, Amanda Rachel Anesthesiology Merrick 287760-3W September 25, 2018
Kundu, Tripali Anesthesiology Melville 290304-5W September 24, 2018
Mullally, Lena Qiaoling Anesthesiology Lido Beach 294272-0W September 19, 2018
O’Neill, Daniel John Anesthesiology New York 292446-2W September 24, 2018
Peacock, Jennifer Nicole Anesthesiology Long Island City 277672-2W September 12, 2018
Ruby, Jordan Max Anesthesiology New York 292779-6W September 24, 2018
Sverdlova, Julia Anesthesiology Smithtown 282724-4W September 24, 2018
Storey, James Andrew Cardiovascular Disease, Clinical Cardiac Electrophysiology Elmira 287699-6W September 20, 2018
Brandt, Kathleen Frances Chiropractic Liberty C13131-0B September 28, 2018
Chouinard, Ginger L. Chiropractic Huntington Station C08093-9W September 28, 2018
Christensen, Shelley Ann Chiropractic Manlius C12904-1B September 28, 2018
Chzechowski, Cara Rae Chiropractic Holland C13055-1B September 28, 2018
Gebraiel, Peter Chiropractic Staten Island C12629-4W September 28, 2018
Gilmore, Jennifer Lynn Chiropractic Tonawanda C12901-7W September 28, 2018
Lacroix, Brad Chiropractic Brooklyn C12121-2W September 28, 2018
Al-Haddad, Marwan Mohammad Dermatology New Hartford 295454-3B September 28, 2018
Agarwal, Sheela Diagnostic Radiology New York 285504-7W September 24, 2018
Agonafer, Senayet Dereje Diagnostic Radiology New York 285336-4W September 24, 2018
Baron, Keren Tuvia Diagnostic Radiology New York 250467-8W September 24, 2018
Chin, Christopher Mark Diagnostic Radiology Brooklyn 262081-3W September 18, 2018
Dieudonne, Gregory Diagnostic Radiology Rochester 245738-0W September 24, 2018
Gong, Richard Wah Diagnostic Radiology Rochester 256327-8W September 24, 2018
Joshi, Vivek Diagnostic Radiology Mineola 269215-0B September 12, 2018
Kuong, Sharon Jane Diagnostic Radiology Brooklyn 240815-1W September 19, 2018
Mathew, Nija Isabel Diagnostic Radiology Mineola 250772-1W September 12, 2018
Oppenheimer, Daniel Corey Diagnostic Radiology West Henrietta 287183-8W September 20, 2018
Safir, Julian Diagnostic Radiology Old Westbury 191860-6B September 12, 2018
Cruz-Menoyo, Priscilla Marie Emergency Medicine Stony Brook 292679-8W September 24, 2018
Dynof, Francis Ronald Emergency Medicine Yonkers 134859-8W September 25, 2018
English, Bryan Patrick Emergency Medicine Stony Brook 292896-8W September 24, 2018
Gordon, David Hirsch Emergency Medicine Stony Brook 294519-4W September 24, 2018
Lohse, Matthew Robert Emergency Medicine Stony Brook 293137-6W September 24, 2018
Adiletta, Christopher Michael Family Practice East Syracuse 292969-3W September 19, 2018
Di Bari, Jeremy Andrew Family Practice Queensbury 295127-5W September 18, 2018
Khan, Asma Family Practice Nyack 261833-8I September 28, 2018
La Rosa, Francesca Vincenza Family Practice Levittown 281399-6W September 18, 2018
Matalia, Neil B. Family Practice Nanuet 287026-9B September 18, 2018
Nagrare, Nupur Family Practice Ogdensburg 290759-0W September 24, 2018
Abraham, Ami Internal Medicine, Pulmonary Disease, Critical Care Medicine East Setauket 262687-7W September 24, 2018
Adams, Hugh William Internal Medicine, Pediatrics Rochester 292685-5W September 24, 2018
Ahmad, Anees Internal Medicine Amherst 237483-3W September 24, 2018
Clores, Michael James Internal Medicine Stony Brook 292533-7W September 24, 2018
Coch, Reilly Washington Internal Medicine, Endocrinology, Diabetes and Metabolism Ithaca 245671-3W September 20, 2018
Khan, Sara Atiq Internal Medicine Stony Brook 294424-7W September 24, 2018
Kim, Steven Namgi Internal Medicine New York 209838-2W September 24, 2018
Koul, Suneel Mohan Internal Medicine Pittsford 208275-8B September 19, 2018
Kuperberg, Stephen J. Internal Medicine, Pulmonary Disease, Critical Care Medicine Stony Brook 266079-3B September 24, 2018
Patel, Ishan Jitendra Internal Medicine Stony Brook 292059-3W September 24, 2018
Reyes, Raquel Internal Medicine, Pediatrics Geneva 268898-4W September 20, 2018
Shah, Ronak Tushar Internal Medicine, Pulmonary Disease Stony Brook 281096-8W September 24, 2018
Treidler, Simona Octaviana Internal Medicine, Neurology Stony Brook 282831-7W September 24, 2018
Galgano, Michael A. Neurological Surgery Syracuse 294452-8W September 12, 2018
Bezov, David Neurology Brooklyn 268341-5W September 19, 2018
Blond, Benjamin Neil Neurology Stony Brook 292476-9B September 24, 2018
Liebling, Courtney Naomi Brooke Neurology Stony Brook 291520-5W September 24, 2018
Lipton, Ross Eliott Neurology Port Jefferson 202189-7W September 24, 2018
Maindiratta, Reema Neurology Babylon 203259-7B September 19, 2018
Marchidann, Adrian Neurology Stony Brook 263981-3B September 24, 2018
Kutsenok, Anna Victorovna Obstetrics/Gynecology Stony Brook 294451-0W September 24, 2018
Belliappa, Sonia Ophthalmology Pomona 257944-9B September 24, 2018
Bouchard, Chad Phillip Ophthalmology Slingerlands 293837-1W September 19, 2018
Reynolds, Andrew Lindell Ophthalmology Buffalo 284890-1W September 18, 2018
Belkin, Nicole Stephanie Orthopedic Surgery Peekskill 278273-8W September 25, 2018
Brown, Landon Dean Orthopedic Surgery Poughkeepsie 293986-6W September 18, 2018
Cody, Elizabeth Ann Orthopedic Surgery New York 271745-2W September 28, 2018
Donovan, Daniel Stephen Orthopedic Surgery Albany 271418-6W September 12, 2018
Dykes, Daryll Christopher Orthopedic Surgery East Syracuse 292638-4B September 12, 2018
Mahmood, Bilal Orthopedic Surgery, Hand Surgery Clifton Park 271758-5W September 20, 2018
Mantica, Abigail Louise Orthopedic Surgery Albany 295034-3W September 18, 2018
O’Donnell, Marc Jerome Orthopedic Surgery, Hand Surgery Rochester 295438-6W September 20, 2018
Riggs, Cassandra Nicole Orthopedic Surgery Syracuse 294454-4W September 18, 2018
Seigerman, Daniel Allan Orthopedic Surgery Tarrytown 294516-0B September 25, 2018
Tombler, Richard Dany Orthopedic Surgery Canton 271448-3W September 28, 2018
Rieth, Katherine Keiko Suzuki Otolaryngology Rochester 294112-8W September 24, 2018
Sakano, Hitomi Otolaryngology Rochester 293768-8W September 20, 2018
Quirolgico, Kristina Marie Physical Medicine/Rehabilitation New York 293421-4W September 12, 2018
Esmond, Gerald A. Podiatry Port Washington P05582-3B September 17, 2018
Lovell, Christopher Lee Podiatry Mount Kisco P06790-1W September 17, 2018
Tsvaygenbaum, Raisa Podiatry Lake Katrine P06874-3B September 17, 2018
Verbofsky, Evan Michael Podiatry Rochester P06921-2W September 17, 2018
Vysotskyy, Taras Podiatry Poughkeepsie P06852-9W September 17, 2018
Wong, David Tom Podiatry Bronx P06302-5B September 17, 2018
Broughton, John M. Psychology New York S05556-6W September 27, 2018
Cooper, Marty Aaron Psychology New York S21944-4W September 27, 2018
Fraser, Suzanne Rowland Psychology Tupper Lake S15429-4W September 27, 2018
Kalmanson, Julia Psychology Mount Kisco S21142-5B September 27, 2018
Kramer, Alexis Joann Psychology Staten Island S21150-8W September 27, 2018
Lozano, Christian Ivan Psychology Queens S22480-8W September 27, 2018
Monge, Angela Psychology Bronx S21814-9W September 27, 2018
Moss, Jennifer Ruth Psychology New York S22174-7W September 27, 2018
Ostroy, Elena W. Psychology Elmhurst S16854-2B September 27, 2018
Renedo, Julia Isabel Psychology Great Neck S22359-4W September 27, 2018
Robinson, Elfe Kulinna Psychology Woodstock S14395-8I September 27, 2018
Seskin, Lynn Psychology Huntington S18387-1W September 27, 2018
Tannenbaum, Lori Psychology Elmhurst S17780-8W September 27, 2018
Warner, Matthew Lloyd Psychology Fishkill S10839-9W September 27, 2018
Ottavio, Peter Pulmonary Disease, Critical Care Medicine East Setauket 232660-1W September 24, 2018
Ali, Sara Radiology – Diagnostic Radiology New York 288112-6W September 24, 2018
Giampa, Joseph Michael Radiology – Diagnostic Radiology Latham 292617-8W September 18, 2018
Gupta, Subah Radiology – Diagnostic Radiology, Neuroradiology Brooklyn 287211-7W September 19, 2018
Liu, Corinne Radiology – Diagnostic Radiology Mineola 254485-6W September 12, 2018
Margulis, Yevgeniy Radiology – Diagnostic Radiology, Neuroradiology Brooklyn 222819-5W September 19, 2018

* Providers authorized to treat and perform independent medical examinations have an authorization number ending in B. Providers authorized to only treat have an authorization number ending in W. Providers authorized to only perform independent medical examinations have an authorization number ending in I.

Any questions regarding the authorized lists should be referred to the Medical Director’s Office at 1 (800) 781-2362.

Clarissa M. Rodriguez
Chair