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Subject Number 046-1348 Changes to the List of Health Care Providers Authorized to Render Services to Injured Workers Under the Workers’ Compensation Law

Subject Numbers Regarding Health Provider Authorizations

November 18, 2020

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
Aftab, Munib Cooperstown 285091-5W September 16, 2020
Arendash-Durand, Barbara Ellen Merrick 198741-1W September 16, 2020
Pirmohamed, Sabera Jamaica 262256-1W September 16, 2020
Bellaousov, Katsiaryna Rochester 281013-3W September 16, 2020
Berkowitz, Daniel Larchmont 109145-3W September 16, 2020
Bloch, Naomi New York PT042283-2W September 16, 2020
Boris, Jacob Tappan 088020-3W September 16, 2020
Boyle, Michael F. Leesburg 252288-6W September 18, 2020
Brandt, Max New York 079422-2W September 16, 2020
Brodsky, Robert Michael Brooklyn C02709-6B September 16, 2020
Campo, Kevin Matthew St. James C08428-7B September 16, 2020
Campos, Otto McClenny 103035-2W September 16, 2020
Chiaramonte, Lawrence Thomas Bronx 093763-1W September 16, 2020
Cobbett, Lindsey Elizabeth Mount Kisco 279069-9W September 16, 2020
Collins, Daniel George Latham 294050-0W September 18, 2020
Conigliaro, Vincent S. New York 083001-8W September 16, 2020
Crowe, Karen Gisotti Albany 267215-2W September 16, 2020
De Mocker, John C. Gaithersburg 077790-4B September 16, 2020
Defeo, Joseph F. New York 128520-4W September 16, 2020
Denier, Donna Patricia Boone 203907-1W September 16, 2020
Dhar, Manorama Demarest 133070-3W September 16, 2020
Dintenfass, Nancy Jill Sands Point 143631-0W September 18, 2020
Dolich, Barry Howard White Plains 100185-8W September 16, 2020
Ferraraccio, William David Syracuse 214122-4I September 18, 2020
Flokas, Constantine Evangelos Yonkers 117461-1W September 16, 2020
Foster, Charles Stephen Waltham 242611-2W September 16, 2020
Cimino-Gandolfo, Lisa Hilary Boston 185190-6W September 16, 2020
Gehl, Michael B. Rochester 124924-2W September 16, 2020
Ghelman, Bernard Cliffside Park 099957-3W September 17, 2020
Glazier, William Lloyd Hiram 082492-0W September 18, 2020
Goldman, Elizabeth K. White Plains 118851-5W September 17, 2020
Gonzalez, Lorena Syracuse 275512-2W September 17, 2020
Gonzalez, Ubaldo New Suffolk 099963-1W September 17, 2020
Hoffman, Daniel Paul Poughkeepsie 113147-3W September 18, 2020
Hotson, Gwendolyn Cara New York 137967-6B September 17, 2020
Hussain, Mahammad Naushad Sugar Land 235125-2W September 17, 2020
Kelley, Geraldine Krypel Orchard Park 131207-3W September 17, 2020
Kelly, Stephen E. New York 125118-0W September 17, 2020
Kelman, Gary J. Huntington 139502-9B September 17, 2020
Kim, Jai Rensselaer 233212-0B September 17, 2020
Kleppel, Noel Harvey Lawrence 079481-8B September 17, 2020
Koppenheffer, Peter Brooks Saranac Lake 269392-7W September 16, 2020
Kwon, Anne Lagrangeville 279877-5W September 16, 2020
Leong, Enriqueta C. Staten Island 121618-3W September 16, 2020
Levy, Lawrence F. Stuart C06017-0W September 16, 2020
Logan, Rodney Dennis Perry 146686-1W September 16, 2020
Losco, Donna Marie Greenlawn 199123-1W September 16, 2020
Lowy, George Long Beach 095500-5W September 16, 2020
Lukawski, Zbigniew A. Clifton Springs 196743-9W September 16, 2020
Madden, Timothy Francis Kingston 279192-9W September 16, 2020
Mayo, Monique Brooklyn C12169-1I September 16, 2020
Michael, Shannon Scully Syracuse 294005-4W September 16, 2020
Namon, Ari J Poughkeepsie 215691-7B September 16, 2020
Nichols, David P. Issaquah 132972-1W September 16, 2020
Novick, Laurence I. Boca Raton 087695-3W September 16, 2020
Patil, Arun Brijlal Whitesboro 151026-2W September 16, 2020
Pellegrino, Raymond East Islip C08404-8B September 16, 2020
Podany, Wendy Ann Stony Brook 294061-7W September 16, 2020
Pottanat, Joseph V. Massapequa 111736-5W September 16, 2020
Poulose-Redger, Ellen Maria Stony Brook 294202-7W September 16, 2020
Ramkishun, Charles Anthony Stony Brook 294126-8W September 16, 2020
Ramsey, Walter Stanley, Jr. Huntington 111853-8W September 16, 2020
Reidy, James Patrick Rochester 142831-7W September 16, 2020
Rekhi, Brij M. Pittsford 121758-7W September 16, 2020
Restivo, Kathleen Mary New Hyde Park 191773-1W September 16, 2020
Santoro, Michael S. E Meadow 127555-1W September 16, 2020
Santucci, Thomas, Jr. Valley Stream 094571-7W September 16, 2020
Sarpel, Gunseli Grand Island 181948-1B September 16, 2020
Sathiyadevan, Niruja Rochester 293882-7W September 16, 2020
Schwartz, Walter Frank New York 086717-6W September 16, 2020
Shah, Ashok N. Rochester 109230-3W September 16, 2020
Shiple, David A. South Burlington 270012-8W September 16, 2020
Simon, Samuel G. Poughkeepsie 129660-7W September 16, 2020
Skonberg, Kenneth Drew Beacon C05104-7B September 16, 2020
Stevenson, Caitlin Marie Brooklyn 289201-6W September 16, 2020
Tanzman, Esther S. Rochester 148632-3W September 16, 2020
Tramontana, Timothy Frank Liverpool 259256-6W September 16, 2020
Wagman, Richard Jay Brooklyn 081647-0B September 16, 2020
Watson, James Curtis Canandaigua C03251-8W September 16, 2020
Weinhoff, Martin Leonard Hewlett 109337-6B September 16, 2020
Wolff, John L. E. White Plains 075064-6W September 16, 2020
Wu, Benson Ming-Shun Irving 203178-9W September 16, 2020
Yadlapalli, Brahmananda Rao Garden City 162454-3B September 16, 2020
Yeo, Albert White Plains 277831-4W September 16, 2020

*Providers authorized to treat and perform independent medical examinations have an authorization number ending in B. Providers authorized to only treat have an authorization number ending in W. Providers authorized to only perform independent medical examinations 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.

Clarissa M. Rodriguez
Chair