Subject Numbers Regarding Health Provider Authorizations
December 11, 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 |
|---|---|---|---|
| Ali, Zafer | Rhinebeck | 107942-5W | October 26, 2020 |
| Ball, Thomas Harold | Cape Coral | 205163-9W | October 26, 2020 |
| Bergamini, Herbert Van Wie | Lake Placid | 079295-2W | October 26, 2020 |
| Berley, Steven Andrew | Boulder | 152534-4B | October 26, 2020 |
| Cancel, David | Jackson Heights | C08589-6W | October 26, 2020 |
| Chandler, Elizabeth J. | Palm Coast | 252645-7B | October 26, 2020 |
| Chinnasamy, Ramya | Chesterfield | 277043-6W | October 26, 2020 |
| Cohen, Abraham | White Plains | 095411-5B | October 26, 2020 |
| Conciatori, Anthony Hugo | Studio City | 252218-3B | October 26, 2020 |
| D'Cunha, Nicholas Cyril | Lubbock | 214053-1W | October 26, 2020 |
| De Blasi, Henry Philip | New Rochelle | 078341-5W | October 26, 2020 |
| Decarlo, Roland Edmund | New Hartford | C08689-4W | October 26, 2020 |
| Dolginova, Elena A. | Niskayuna | PT020584-9W | October 26, 2020 |
| Dupont, Paul G. | Eden Prairie | 197359-3W | October 27, 2020 |
| Erickson, Alex | Maitland | C12966-0I | October 27, 2020 |
| Fasanello, Richard Anthony | Conover | 150554-4W | October 27, 2020 |
| Feinstein, Edward D. | Saratoga Springs | 109114-9W | October 27, 2020 |
| Field, Lauren J. Prusnofsky | New Bedford | 279937-7W | October 27, 2020 |
| Flannagan, David Michael | Sarasota | 165989-5W | October 27, 2020 |
| Ford, John P. | Oneida | 128183-1W | October 27, 2020 |
| Friedman, Ross | Bronxville | 158914-2W | October 27, 2020 |
| Garwood, Elisabeth | New York | 278729-9W | October 27, 2020 |
| Germano, William J. | Hauppauge | C06918-9B | October 27, 2020 |
| Gokhale, Amit Arun | Stony Brook | 294483-3W | October 27, 2020 |
| Goldfarb, Herman | Monticello | 087743-1W | October 27, 2020 |
| Golding, Michael R. | Morganville | 084590-9W | October 27, 2020 |
| Gordon, David Hirsch | Stony Brook | 294519-4W | October 27, 2020 |
| Goyal, Ameet Kumar | Rye | 199483-9W | October 27, 2020 |
| Grillo, James F. | Yonkers | 120664-8W | October 27, 2020 |
| Hira, Jai Singh | New Hyde Park | 267425-7B | October 27, 2020 |
| Hogge, Mark Wayne | Jamestown | 286556-6W | October 27, 2020 |
| Iacona, Marie Ann | Amherst | 176737-5W | October 27, 2020 |
| Jagga, Sudarshan Kumar | New Hyde Park | 118526-3W | October 27, 2020 |
| Jean-Charles, Nadie Carmel | Orlando | 228016-2W | October 27, 2020 |
| Kaganovsky, Y. Lazar | Brooklyn | 167701-2W | October 27, 2020 |
| Kalish, Scott L. | New York | 154308-1W | October 27, 2020 |
| Kohn, Arlene Frances | Manhassett | P05131-9W | October 27, 2020 |
| Krepostman, Jaime I. | Albany | 125898-7B | October 26, 2020 |
| Lagaly, William J. | Athens | 259734-2W | October 26, 2020 |
| Leggiadro, Peter | Port Chester | 086645-9W | October 26, 2020 |
| Lenci, Magaret M. | Granite Springs | 147929-4W | October 26, 2020 |
| Lindenmuth, Norman William | Keuka | 121972-4W | October 26, 2020 |
| Madajewicz, Stefan | Hastings on Hudson | 136235-9W | October 26, 2020 |
| Malizia, Carol Ann | Newburgh | C05970-1W | October 26, 2020 |
| Manzione, James V. | Portland | 154353-7W | October 26, 2020 |
| Matta, Yesu Kumar | Norwich | 280241-1W | October 26, 2020 |
| Mazzara, James T. | Little Neck | 092892-9W | October 26, 2020 |
| Mc Galey, John | Syosset | 049184-5W | October 26, 2020 |
| Moqtaderi, Fazlollah Fraydoon | Irvington | 117692-4W | October 26, 2020 |
| Mowla, Mohammed Rashedul | Houston | 258437-3W | October 26, 2020 |
| Nassar, Munir E. | Pittsford | 124947-3W | October 26, 2020 |
| Navarro, Zoraida | New Hyde Park | 156204-0W | October 26, 2020 |
| Norton, Sylvia W. | Syracuse | 132600-8B | October 26, 2020 |
| Nubani, Lu'ay Ismail | Syracuse | 286948-5W | October 26, 2020 |
| Parithivel, Vellore S. | Raleigh | 135004-0W | October 26, 2020 |
| Peeler, Norman Clayton | New York | 126636-0W | October 26, 2020 |
| Pryce, Michael Lindsey | Cortland | 280178-5W | October 26, 2020 |
| Qiu, Ann Jin | New York | 198620-7W | October 26, 2020 |
| Quereshy, Mahmood A. | New Hartford | 113713-2B | October 26, 2020 |
| Rao, Ramani Muppavarapu | Canandaigua | 151431-4B | October 26, 2020 |
| Repetto, Vittoria A. | New York | C04749-0W | October 26, 2020 |
| Rezak, Kristen Marie | Albany | 239581-2W | October 26, 2020 |
| Sadik, Abdul Rasul | Teaneck | 102465-2W | October 26, 2020 |
| Schultz, Stephen | Staatsburgh | 109589-2W | October 26, 2020 |
| Scott, Roger Edward | Deposit | 211629-1W | October 26, 2020 |
| Shuttleworth, David | Rochester | 100197-3W | October 26, 2020 |
| Silverberg, Mervin | New York | 099857-5W | October 26, 2020 |
| Song, Cherry | Springfield | 280069-6W | October 26, 2020 |
| Subramaniam, Arumbi P. | Chappaqua | 122225-6W | October 26, 2020 |
| Telem, Dana Alexa | Ann Arbor | 243429-8W | October 26, 2020 |
| Thompson, Mavis Sarah | Bronx | 076153-6W | October 26, 2020 |
| Vella, Jacob Anthony | Syracuse | 269295-2W | October 26, 2020 |
| Warren, Luther Fiske | New York | 105856-9W | October 26, 2020 |
| Wharton, Seth W. | Glenville | 162049-1B | October 26, 2020 |
| Wilson, Charles Richard | Great Falls | 250042-9W | October 26, 2020 |
| Wilson, Wendal | Rochester | OT002304-4W | October 26, 2020 |
| Zola, Seymour Paul | Blue Point | 049487-2W | October 26, 2020 |
*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