Subject Numbers Regarding Health Provider Authorizations

NOTICE OF RESCISSION OF REGISTRATION OF IME ENTITY:
NORTHEAST MEDICAL EVALUATION & DIAGNOSTIC SERVICES

June 25, 2004

Effective June 26, 2004, the New York State Workers' Compensation Board is rescinding the designation of Northeast Medical Evaluation and Diagnostic Services, P.C. as an entity registered to derive income from independent medical examinations in workers' compensation cases. This rescission is made pursuant to Section 13-n of the Workers' Compensation Law and 12 NYCRR 300.2 (e). This rescission is permanent. The entity's address is:

Northeast Medical Evaluation and Diagnostic Services, P.C.
900 Merchants Concourse
Westbury, New York 11590

On the effective date of this rescission, the entity named above is permanently prohibited from deriving income from independent medical examinations in workers' compensation cases. Examinations conducted prior to June 26, 2004 are valid.

Any questions regarding this matter should be referred to the Office of General Counsel at (518) 486-7676.

David P. Wehner
Chairman