Subject Numbers Regarding Health Provider Authorizations

Authorization No. 154114-3W

May 7, 2013

Please be advised that Dr. Clementina Lewis' authorization to treat injured workers in the New York State workers' compensation system has been suspended indefinitely effective March 26, 2013. Dr. Lewis' last known business address is 1856 Colvin Boulevard, Tonawanda, New York, 14150.

Dr. Lewis is prohibited from rendering treatment and care to injured workers while her authorization is suspended. Reports submitted by Dr. Lewis for services rendered prior to March 26, 2013, are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Lewis for services rendered prior to March 26, 2013, should not be denied due to the suspension of her authorization.

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