Subject Numbers Regarding Health Provider Authorizations

Authorization No. 233930-7W

February 10, 2022

Please be advised that Dr. Muhammad Asad Mirza has resigned his authorization to treat injured workers in the New York State workers' compensation system effective February 9, 2022. Dr. Mirza's last known practice addresses are:

NYC Madison Ave Med, P.C.
440 Audubon Avenue
New York, New York 10040

NYC Madison Ave Med, P.C.
6 Gramatan Avenue
Mt. Vernon, New York 10550

NYC Madison Ave Med, P.C.
84-11 Queen Boulevard
Elmhurst, New York 11373

Dr. Mirza is prohibited from rendering treatment and care to injured workers, and from conducting reviews of records regarding variance requests pursuant to 12 NYCRR § 324.3(b)(2)(ii)(a). Reports submitted by Dr. Mirza for services rendered prior to February 9, 2022, are valid but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Mirza for services rendered prior to February 9, 2022, should not be denied due to his resignation.

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