Subject Numbers Regarding Health Provider Authorizations
February 27, 2020
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 |
|---|---|---|---|
| Amajoyi, Robert | Valley Stream | 273853-2W | December 16, 2019 |
| August, Lawrence Edward | Brooklyn | C01688-3W | December 16, 2019 |
| Balderman, Samuel Calvin | Buffalo | 137463-6W | December 16, 2019 |
| Bencardino, Jenny Teresa | Jericho | 238787-6W | December 16, 2019 |
| Berrios, Ramon | Marietta | 127718-5W | December 16, 2019 |
| Bozic, Stanimir | Pound Ridge | 138853-7W | December 16, 2019 |
| Campbell, Christina L. | Johnson City | 291037-0W | December 16, 2019 |
| Chundru Usha | Cresskill | 239960-8W | December 16, 2019 |
| Chung, Jae Won | Edgewater | 234823-3W | December 16, 2019 |
| Dave, Vinnidhy | New York | 275556-9W | December 16, 2019 |
| Denaro, Jack A. | New York | 110624-4W | December 16, 2019 |
| Diamond, Burton S. | Great Neck | 095943-7W | December 16, 2019 |
| Faimon, Jack I. | Fresh Meadows | C03739-2W | December 16, 2019 |
| Ferguson, Ruth | Southampton | 091188-3W | December 16, 2019 |
| Fine, Leslie | Hewlett Harbor | 084345-8W | December 16, 2019 |
| Folger, Walter Howland | Albany | 209781-4W | December 16, 2019 |
| Garvey, Julius W. | Fresh Meadows | 107943-3W | December 16, 2019 |
| Gebert, John Kevin | Mechanicville | 134994-3W | December 16, 2019 |
| Gelbard, Bernard | Malone | 128127-8W | December 16, 2019 |
| Giordano, John Joseph | Hauppauge | 089309-9W | December 16, 2019 |
| Gray, Cynthia E. | White Plains | 144432-2W | December 16, 2019 |
| Greenberg, Robert H. | Bronx | C04023-0W | December 16, 2019 |
| Gutierrez, Silvia M. | Miami Beach | 164246-1W | December 16, 2019 |
| Harder, Joseph A. | Bellport | 070487-4W | December 16, 2019 |
| Huang, Ching-Huang | Warwick | 164972-2W | December 16, 2019 |
| Jacobs, Fred I. | Saratoga Springs | P02814-3W | December 16, 2019 |
| Jubelt, Burk | Syracuse | 116715-4W | December 16, 2019 |
| Kapasi, Amarish R. | Atlanta | 223511-7W | December 16, 2019 |
| Kephart, Phyllis A. | Prattsburgh | 181992-9W | December 16, 2019 |
| Khan, Arfa | Jericho | 109926-6W | December 16, 2019 |
| Kiefer, Daniel George | Orlando | 239801-1W | December 16, 2019 |
| Kim, In Tae | Rochester | 274769-9W | December 16, 2019 |
| Koda, Emi Amy | Orchard Park | 290892-9W | December 16, 2019 |
| Leggio, Joanne Maria | Albany | C05493-4W | December 16, 2019 |
| Litchmore, Trevor Alexander | Schenectady | 193012-2W | December 16, 2019 |
| Lowinson, Joyce H. | New York | 091521-5W | December 16, 2019 |
| Maglione, Paul J. | Ossining | P02544-6W | December 16, 2019 |
| Majithia, Narendra H. | Myrtle Beach | 134178-3W | December 16, 2019 |
| Mendelsohn, Frederick Sydney | New York | 083923-3W | December 16, 2019 |
| Milstein, Harold | Chatham | 134763-2W | December 16, 2019 |
| Mitchell, Thomas R. | Port Myers | 180983-9W | December 16, 2019 |
| Naidu, Sandeep | Eden Prairie | 247777-6W | December 16, 2019 |
| Painton, J. Frederick, Jr. | Williamsville | 094668-1W | December 16, 2019 |
| Palmer, Kenneth David | Houston | 188445-1B | December 16, 2019 |
| Peralo, Charles Anthony | Rock Hill | 197721-4W | December 16, 2019 |
| Rainstein, Miguel A. | Estero | 133539-7W | December 16, 2019 |
| Ratanawongsa, Boonlua | Olean | 118639-4W | December 16, 2019 |
| Rosenbaum, Siegfried | Floral Park | 109435-8W | December 16, 2019 |
| Seaman, Gideon | La Jolia | 081366-7W | December 16, 2019 |
| Semel-Concepcion, Jennifer J. | Port Jefferson | 193282-1W | December 16, 2019 |
| Shetty, Kadandale Ravindranath | Manhasset | 110501-4W | December 16, 2019 |
| Simon, Sidney | White Plains | 070551-7W | December 16, 2019 |
| Singh, Monika | Northborough | 255848-4W | December 16, 2019 |
| So, Rosa Sy | Brooklyn | 111941-1W | December 16, 2019 |
| Sonoda, Myung Park | Tuckahoe | 103194-7W | December 16, 2019 |
| Spiegelman, Morton | Rydal | 072601-8W | December 16, 2019 |
| Stampur, Henry L. | Port Chester | 112615-0W | December 16, 2019 |
| Stanistreet, Bryan J. | Rochester | 276576-6W | December 16, 2019 |
| Stein, Alfred M. | Williamsville | 082531-5W | December 16, 2019 |
| Stewart, Edmunde Andrew Cameron | Port Jefferson | 093356-4B | December 16, 2019 |
| Sun, Yue | Albany | 282844-0W | December 16, 2019 |
| Tolge, Bruno Paul | Schenectady | 088151-6W | December 16, 2019 |
| Tomy, Mercy Kuttentharappel | Williamsville | 285204-4W | December 16, 2019 |
| Trimboli, Joseph Rocco | Victor | C12892-8W | December 17, 2019 |
| Vairavamurthy, Darshan Wimal | Middletown | 269329-9W | December 17, 2019 |
| Villafuerte, Ceferino Reyes | Greenwich | 105492-3W | December 17, 2019 |
| Walker, James T. | Centerport | 143375-4W | December 17, 2019 |
| Weiser, Stephen M. | Pleasantville | 131791-6W | December 17, 2019 |
| Weiss, Jerome | Boynton Beach | 043098-3W | December 17, 2019 |
| Wiedman, Melvin L. | Manhasset | 082495-3W | December 17, 2019 |
| Wilcox, Guy Hartley | Sauquoit | 131403-8W | December 17, 2019 |
| Woo, Myung Shik | New York | 126727-7W | December 17, 2019 |
| Woolf, George | Middletown | 084949-7W | December 17, 2019 |
| Yang, Chin Tsun | Rockville Centre | 117984-5W | December 17, 2019 |
| Zakow, Peter K. | Poughkeepsie | 195399-1W | December 17, 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