Subject Numbers Regarding Health Provider Authorizations

Authorization No. 195230-8W

September 24, 2013

Please be advised that Dr. Danuta Derkatz has resigned his/her authorization to treat injured workers in the New York State workers' compensation system effective September 19, 2013. Dr. Derkatz's last known practice address is 8875 Porter Road, Niagara Falls, NY 14304.

Dr. Derkatz is prohibited from rendering treatment and care to injured workers. Reports submitted by Dr. Derkatz for services rendered prior to September 19, 2013, are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Derkatz for services rendered prior to September 19, 2013, should not be denied due to his/her resignation.

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