Subject Numbers Regarding Health Provider Authorizations
June 12, 2014
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 |
|---|---|---|---|
| Babe, John J | Queensbury | 109028-1W | April 11, 2014 |
| Barrau, Lionel P | Glen Cove | 114445-0W | April 11, 2014 |
| Bulger, Jennifer Leigh | Hamburg | C11965-3B | April 11, 2014 |
| Burman, William Davies | Monroe | 169163-3W | April 11, 2014 |
| Clough, David V | Gloversville | 090253-6W | April 11, 2014 |
| De Cann, Tonya J | Newark | C11127-0W | April 11, 2014 |
| Durrani, Shakeel Farrukh | Horseheads | 256019-1W | April 11, 2014 |
| Giusti, Claire | Monroe | C03599-0W | April 11, 2014 |
| Gold, Marthe Rachael | New York | 147128-3W | April 11, 2014 |
| Goodman, Barry Jay | Island Park | C05343-1W | April 11, 2014 |
| Gross, Richard Eton | Westbury | C07621-8B | April 11, 2014 |
| Heikal, Mohamed O | Fayetteville | 263679-3W | April 11, 2014 |
| Jampol, Jason Adam | Port Jefferson Station | C09383-3W | April 11, 2014 |
| Kane, Neal David | Nyack | 166569-4W | April 11, 2014 |
| Krafte, Burton O | Philmont | 083787-2W | April 11, 2014 |
| Kuri, John Anthony | Massapequa | 247323-9W | April 11, 2014 |
| Lee, Chong T | Vestal | 128642-6W | April 11, 2014 |
| Leeson, Susan Hume | Syracuse | 159863-0W | April 11, 2014 |
| Lochner, Jon C | La Fayette | 127712-8W | April 11, 2014 |
| Mahon, William A | Oswego | 142323-5B | April 11, 2014 |
| Mehalic, Theodore C | New Hartford | 125181-8W | April 11, 2014 |
| Novak, Michael Peter | Schenectady | 090885-5W | April 11, 2014 |
| Raggi, Robert P | New York | 143564-3W | April 11, 2014 |
| Revzin, Margarita V | Brooklyn | 247710-7B | April 11, 2014 |
| Rivers, Margaret Macdougall | Syracuse | 211881-8W | April 11, 2014 |
| Robin, Murray | Babylon | 071603-5W | April 11, 2014 |
| Ross, Stanley | Great Neck | 082217-1B | April 11, 2014 |
| Setton, Haym Victor | Bayside | 110194-8W | April 11, 2014 |
| Shafer, Nathaniel | New York | 076953-9B | April 11, 2014 |
| Tan, Conchita | Orchard Park | 117914-2W | April 11, 2014 |
| Tepper, Judith Presberg | Chappaqua | 176748-2W | April 11, 2014 |
| Palanisamy, Viswakumar | Slate Hill | 139336-2W | April 11, 2014 |
| Weil, Inga F | Beechhurst | 047336-3W | April 11, 2014 |
| Wells, Richard J | Syracuse | 092865-5W | April 11, 2014 |
| White, Bruce D | Mahopac | 129065-9W | April 11, 2014 |
| Wigdor, Aaron A | Port Jefferson | 088103-7W | April 11, 2014 |
| Wright, Megan Patricia | Saranac Lake | 233069-4W | April 11, 2014 |
| Yarwood, Edwin Howard | Liverpool | 089451-9W | April 11, 2014 |
* Providers authorized to treat only, have an authorization number ending in "W" – Providers authorized to treat and perform independent medical examinations, have an authorization number ending in "B" – Providers authorized to perform independent medical examinations only, 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.
Robert E. Beloten
Chair