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Subject Number 046-1217 Changes to the List of Health Care Providers Authorized to Render Services to Injured Workers Under the Workers' Compensation Law

Subject Numbers Regarding Health Provider Authorizations

October 9, 2019

Pursuant to Workers’ Compensation Law § 13-b, a provider must be licensed and registered with the New York State Education Department in order to maintain a Workers’ Compensation Board authorization(s).

The following have been removed from the list of providers authorized to treat injured workers and/or perform independent medical examinations within the New York State workers’ compensation system based on information provided by the New York State Education Department indicating that they do not currently have an active license to practice medicine in New York State.

NAME LAST KNOWN CITY OF PRACTICE AUTHORIZATION NUMBER* EFFECTIVE DATE
Averick, Rauvan Micah Houston 154708-2W August 12, 2019
Baerson, Alanne New York S13788-5W August 12, 2019
Bannon, John David Queensbury 136663-2W August 12, 2019
Baram, Lena Diane Washington 189342-9W August 12, 2019
Barra, Edward Peter Rochester P02234-4W August 12, 2019
Belfiore, Michael Vincent Merrick 200906-6W August 12, 2019
Bernstein, Ira Bardonia P05869-4W August 12, 2019
Bhayani, Hansa Hemant Tavares 159382-1W August 12, 2019
Boras, Stephen Cairo C05302-7W August 12, 2019
Burkley, Brandon Robert Red Hook C09296-7W August 12, 2019
Byrom, David Gene Commack S03630-1W August 12, 2019
Cocioba-Botosan, Smaranda Ridgewood 164309-7W August 12, 2019
Contino, Carl A. Getzville 082841-8W August 12, 2019
Cunningham, Eugene E. West Seneca 116171-0W August 12, 2019
Cuti, Jay Vincent Huntington 110864-6W August 12, 2019
Dale, Robert Charles Rochester 106987-1W August 12, 2019
Deshmukh, Madhav Narayan Lockport 158246-9W August 12, 2019
Dinani, Aliraza Dilawer Minneapolis 276058-5W August 12, 2019
Driscoll, Miles E. Vacaville 241582-6W August 12, 2019
Edelstein, Bernard Manhasset Hills 082360-9W August 12, 2019
Ekholm, Sven E. Rochester 153808-1W August 12, 2019
Emad, Jamal Barneveld 093741-7W August 12, 2019
Firooznia, Hossein Scarsdale 109238-6W August 12, 2019
Freiser, Mark A. Hollywood P03084-2W August 12, 2019
Frymoyer, Carolyn Ledda Manlius 137949-4W August 12, 2019
Jean-Charles, Sashenka Erlanger 263588-6w August 12, 2019
Gallagher, Christopher J. Stony Brook 239953-3W August 12, 2019
Gewacke, Marilyn Albany S06617-5W August 12, 2019
Giuliani, Jeffrey Robert Auburn 272468-0W August 12, 2019
Grauer, Seymour David Syosset 085368-9W August 12, 2019
Green Martin Barry Boca Raton C06814-0W August 12, 2019
Greene, John D. Lewiston 126103-1W August 12, 2019
Gusset, George G. New York 086864-6W August 12, 2019
Herrera, Anibal Pedro Middletown 094107-0W August 12, 2019
Kaplan, Roger Rocky Point C01917-6B August 12, 2019
Lassiter, Tally Edward, Jr. Cooperstown 256321-1W August 12, 2019
Leichman, Cynthia Gail New York 209079-3W August 12, 2019
Lesin, Martin L. Port St. Lucie C02056-2W August 12, 2019
Levine, Martin Boynton Beach 086646-7W August 12, 2019
Lewenberg, Adam New York 105605-0W August 12, 2019
Lines, David Ted West Seneca C02578-5W August 12, 2019
Keyes, John L. Dunkirk 129652-4W August 13, 2019
Korn, Jay L. New York 092822-6W August 13, 2019
Kothari, Mayur J. Meadow 145468-5W August 13, 2019
Landes, Arlene Augusta New York S09868-1W August 13, 2019
Larow, Edward Joseph, Jr. Plattsburgh 206341-0W August 13, 2019
Lascola, Robert John Buffalo 098279-3W August 13, 2019
Martin, Raquel Gertrud Williamsville 157556-2W August 13, 2019
McCarthy, Katherine Ann Skaneateles 146570-7W August 13, 2019
Mcclellan, John Baptiste Jamestown 280578-6W August 13, 2019
Mendel, Julius G. Great Neck 079551-8W August 13, 2019
Menkes, Stephen Hudson 103089-9W August 13, 2019
Minor, John Ellis Utica 176034-7W August 13, 2019
Movaghar, Mansoor Setauket 211347-0W August 13, 2019
Nathan, Annette Raquel Dayton 166197-4W August 13, 2019
Nzuzi, Simon M. Hollis P03037-0W August 13, 2019
Ostovar, Raha Atlanta C12827-4W August 13, 2019
Panitz, Lawrence Yonkers 098987-1W August 13, 2019
Polacek, Daniel Joseph Fayetteville 141347-5W August 13, 2019
Propper, Martin Michael Great Neck S03576-6I August 13, 2019
Prushik, Kenneth Howard Huntington 228253-1W August 13, 2019
Purpura, Anthony Graham Staten Island 091283-2W August 13, 2019
Rock, Samuel Man Melville S03905-7W August 13, 2019
Rodricks, Paul Sherman Oaks 198643-9W August 13, 2019
Roen, Janet L. New York 134794-7W August 13, 2019
Romano, Constance Anne Brooklyn P04427-2W August 13, 2019
Rothenberg, Beanne Oneill Boulder S11228-4B August 13, 2019
Rudolph, Martin Life Cedarhurst P02511-5W August 13, 2019
Sarnowski, Robert J. Clarks Summit 263297-4I August 13, 2019
Schoenfeld, Mark R. Springfield 144157-5B August 13, 2019
Schweitzer, Philip Edward Bronx 105455-0W August 13, 2019
Shah, Surendralal G. Oster Bay Cove 133617-1W August 13, 2019
Song, In Chul New York 094064-3W August 13, 2019
Stasior, Orkan George Latham 080808-9W August 13, 2019
Teitelbaum, Marcel West Hempstead S04144-2W August 13, 2019
Tervo, Kristina Marie Chittenango 270560-6W August 13, 2019
Tiemann, Dawn Dugan Brooklyn 291019-8W August 13, 2019
Travin, Sheldon Chappaqua 098358-5W August 13, 2019
Tuyn, John A. Williamsville 087587-2W August 13, 2019
Vengal, Sarah Ann Powell 282091-8W August 13, 2019
Weber, Carl Paul White Plains 093833-2W August 13, 2019
Wright, Susan Marie Williamsville P03344-0W August 13, 2019
Zambuto, Gerlando Brooklyn C12490-1W August 13, 2019

* 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.

These providers are prohibited from rendering treatment and care to injured workers and/or from performing independent medical examinations. Reports submitted for services rendered prior to the effective date are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine any of the above for services rendered prior to the effective date should not be denied due to the removal of their authorizations.

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

Clarissa M. Rodriguez
Chair