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Subject Number 046-1353 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

December 11, 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
Ali, Zafer Rhinebeck 107942-5W October 26, 2020
Ball, Thomas Harold Cape Coral 205163-9W October 26, 2020
Bergamini, Herbert Van Wie Lake Placid 079295-2W October 26, 2020
Berley, Steven Andrew Boulder 152534-4B October 26, 2020
Cancel, David Jackson Heights C08589-6W October 26, 2020
Chandler, Elizabeth J. Palm Coast 252645-7B October 26, 2020
Chinnasamy, Ramya Chesterfield 277043-6W October 26, 2020
Cohen, Abraham White Plains 095411-5B October 26, 2020
Conciatori, Anthony Hugo Studio City 252218-3B October 26, 2020
D'Cunha, Nicholas Cyril Lubbock 214053-1W October 26, 2020
De Blasi, Henry Philip New Rochelle 078341-5W October 26, 2020
Decarlo, Roland Edmund New Hartford C08689-4W October 26, 2020
Dolginova, Elena A. Niskayuna PT020584-9W October 26, 2020
Dupont, Paul G. Eden Prairie 197359-3W October 27, 2020
Erickson, Alex Maitland C12966-0I October 27, 2020
Fasanello, Richard Anthony Conover 150554-4W October 27, 2020
Feinstein, Edward D. Saratoga Springs 109114-9W October 27, 2020
Field, Lauren J. Prusnofsky New Bedford 279937-7W October 27, 2020
Flannagan, David Michael Sarasota 165989-5W October 27, 2020
Ford, John P. Oneida 128183-1W October 27, 2020
Friedman, Ross Bronxville 158914-2W October 27, 2020
Garwood, Elisabeth New York 278729-9W October 27, 2020
Germano, William J. Hauppauge C06918-9B October 27, 2020
Gokhale, Amit Arun Stony Brook 294483-3W October 27, 2020
Goldfarb, Herman Monticello 087743-1W October 27, 2020
Golding, Michael R. Morganville 084590-9W October 27, 2020
Gordon, David Hirsch Stony Brook 294519-4W October 27, 2020
Goyal, Ameet Kumar Rye 199483-9W October 27, 2020
Grillo, James F. Yonkers 120664-8W October 27, 2020
Hira, Jai Singh New Hyde Park 267425-7B October 27, 2020
Hogge, Mark Wayne Jamestown 286556-6W October 27, 2020
Iacona, Marie Ann Amherst 176737-5W October 27, 2020
Jagga, Sudarshan Kumar New Hyde Park 118526-3W October 27, 2020
Jean-Charles, Nadie Carmel Orlando 228016-2W October 27, 2020
Kaganovsky, Y. Lazar Brooklyn 167701-2W October 27, 2020
Kalish, Scott L. New York 154308-1W October 27, 2020
Kohn, Arlene Frances Manhassett P05131-9W October 27, 2020
Krepostman, Jaime I. Albany 125898-7B October 26, 2020
Lagaly, William J. Athens 259734-2W October 26, 2020
Leggiadro, Peter Port Chester 086645-9W October 26, 2020
Lenci,  Magaret M. Granite Springs 147929-4W October 26, 2020
Lindenmuth, Norman William Keuka 121972-4W October 26, 2020
Madajewicz, Stefan Hastings on Hudson 136235-9W October 26, 2020
Malizia, Carol Ann Newburgh C05970-1W October 26, 2020
Manzione, James V. Portland 154353-7W October 26, 2020
Matta, Yesu Kumar Norwich 280241-1W October 26, 2020
Mazzara, James T. Little Neck 092892-9W October 26, 2020
Mc Galey, John Syosset 049184-5W October 26, 2020
Moqtaderi, Fazlollah Fraydoon Irvington 117692-4W October 26, 2020
Mowla, Mohammed Rashedul Houston 258437-3W October 26, 2020
Nassar, Munir E. Pittsford 124947-3W October 26, 2020
Navarro, Zoraida New Hyde Park 156204-0W October 26, 2020
Norton, Sylvia W. Syracuse 132600-8B October 26, 2020
Nubani, Lu'ay Ismail Syracuse 286948-5W October 26, 2020
Parithivel, Vellore S. Raleigh 135004-0W October 26, 2020
Peeler, Norman Clayton New York 126636-0W October 26, 2020
Pryce, Michael Lindsey Cortland 280178-5W October 26, 2020
Qiu, Ann Jin New York 198620-7W October 26, 2020
Quereshy, Mahmood A. New Hartford 113713-2B October 26, 2020
Rao, Ramani Muppavarapu Canandaigua 151431-4B October 26, 2020
Repetto, Vittoria A. New York C04749-0W October 26, 2020
Rezak, Kristen Marie Albany 239581-2W October 26, 2020
Sadik, Abdul Rasul Teaneck 102465-2W October 26, 2020
Schultz, Stephen Staatsburgh 109589-2W October 26, 2020
Scott, Roger Edward Deposit 211629-1W October 26, 2020
Shuttleworth, David Rochester 100197-3W October 26, 2020
Silverberg, Mervin New York 099857-5W October 26, 2020
Song, Cherry Springfield 280069-6W October 26, 2020
Subramaniam, Arumbi P. Chappaqua 122225-6W October 26, 2020
Telem, Dana Alexa Ann Arbor 243429-8W October 26, 2020
Thompson, Mavis Sarah Bronx 076153-6W October 26, 2020
Vella, Jacob Anthony Syracuse 269295-2W October 26, 2020
Warren, Luther Fiske New York 105856-9W October 26, 2020
Wharton, Seth W. Glenville 162049-1B October 26, 2020
Wilson, Charles Richard Great Falls 250042-9W October 26, 2020
Wilson, Wendal Rochester OT002304-4W October 26, 2020
Zola, Seymour Paul Blue Point 049487-2W October 26, 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