Subject Numbers Regarding Health Provider Authorizations
July 1, 2015
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 |
|---|---|---|---|
| Abdelazim, Mohamad | Binghampton | 107181-0W | April 13, 2015 |
| Arena, Angelo | Hannibal | 082475-4W | April 13, 2015 |
| Arkins, Robert Eli | New York | 079285-3W | April 13, 2015 |
| Aust, John Charles | Skaneateles | 112368-6W | April 13, 2015 |
| Bathrick, Charles Ernest | Canandaigua | 071291-9W | April 13, 2015 |
| Bronster, Stephen Mayer | Oceanside | S14363-6B | April 13, 2015 |
| Burris, Harriet L | Alexandria Bay | 131476-4W | April 13, 2015 |
| Colvin, George Leslie | Valley Stream | 088008-8B | April 13, 2015 |
| Dolan, William Austin | Rochester | 107414-5W | April 13, 2015 |
| Eddy, Donnel B | Glens Falls | C09775-0B | April 13, 2015 |
| Ego, Aguirre Ernesto | New York | 103051-9W | April 13, 2015 |
| Genieser, Nancy Branom | New York | 094140-1W | April 14, 2015 |
| Greco, John | Stony Brook | 166212-1W | April 14, 2015 |
| Filardi, Gregory R | Monroe | C02000-0B | April 14, 2015 |
| Forim, Myron A | Woodmere | 081376-6W | April 14, 2015 |
| Garcia, Andrew Scott | Ozone Park | C07588-9W | April 14, 2015 |
| Huber, Michael Stone | Bronx | 168086-7B | April 14, 2015 |
| Iroku, Humphrey A | Bellport | 125949-8W | April 14, 2015 |
| Josen, Avtar Singh | Manhasset | 109913-4W | April 14, 2015 |
| Kahn, Alvin Jerome | New Rochelle | 076538-9W | April 14, 2015 |
| Kaufer, Marshall | Suffern | C00178-6W | April 14, 2015 |
| Kirshbaum, Michael S | West Islip | C07571-5W | April 14, 2015 |
| Krumpholz, Mark Douglas | New Hartford | 149754-4W | April 14, 2015 |
| Lee, Frances Eun-Hyung | Rochester | 197920-2W | April 14, 2015 |
| Lee, Woon Soon | New York | 108380-7W | April 14, 2015 |
| Lou, Gin Wen | Delmar | 268043-7W | April 14, 2015 |
| Lubetsky, Herman W | New York | 077813-4W | April 14, 2015 |
| Mapara, Hashim Abdulrehman | Rome | 254499-7W | April 14, 2015 |
| Marroquin, Bridget Murphy | Rochester | 255302-2W | April 14, 2015 |
| Nash, Amanda Meagan | Albany | C11802-8W | April 14, 2015 |
| Nour, Mohamed K | Whitestone | 126616-2B | April 14, 2015 |
| Parkinson, David Keith | Port Jefferson | 168393-7W | April 14, 2015 |
| Pearl, Marilyn | Great Neck | 079626-8W | April 14, 2015 |
| Pelebecky, George William Jr | Purchase | 108908-5W | April 14, 2015 |
| Richardson, Matthew L | Rochester | C12111-3B | April 14, 2015 |
| Rosenblum, Saul | Auburn | 144966-9W | April 14, 2015 |
| Ross, Brian | Melville | C10595-9W | April 15, 2015 |
| Rutgers, Carol Fay | New York | 097582-1W | April 15, 2015 |
| Savino, Joseph N | Port Washington | 089417-0B | April 15, 2015 |
| Seguritan, Cesar S | Staten Island | 134014-0W | April 15, 2015 |
| Sewell, Clinton James | Cambria Heights | 179357-9W | April 15, 2015 |
| Shapiro, Howard | Brooklyn | C02102-4B | April 15, 2015 |
| Thissell, Judah Briggs | Owego | C12115-4W | April 15, 2015 |
| Tommasino, Melissa Laura | East Setauket | C08781-9B | April 15, 2015 |
| Wickiewicz, Robert George | Valatie | 114150-6W | April 15, 2015 |
* 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