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Subject Number 046-1434 June 2021 Removals from the List of Authorized Health Care Providers

Subject Numbers Regarding Health Provider Authorizations

August 10, 2021

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
Alexander, John A. Hopewell Junction C05929-7B June 30, 2021
Alzheimer, Daniel Robert Lewiston 297596-9B June 30, 2021
Anderson, John Marshall Morristown 207159-5W June 30, 2021
Aye, Than Than Staten Island 151420-7W June 30, 2021
Barthauer, Linda Pittsford 215272-6W June 30, 2021
Bensky, Scott Erik Ramsey C09704-0W June 30, 2021
Berlow, Michael Elliot Lakewood Ranch 136656-6W June 30, 2021
Bhatia, Shamsunder Doulatram Staten Island 107241-2W June 30, 2021
Birnbaum, Israel N. Melville S05888-3W June 30, 2021
Branigan, Thomas Sidney Williamsville 097648-0W June 30, 2021
Brown, Matthew Scott Glens Falls N534579-8W June 30, 2021
Bruhn, Donald Frederick Fort Meyers 082082-9B June 7, 2021
Bylebyl, Joseph Karol Ithaca 145316-6W June 30, 2021
Castellano, Charles Christopher Westfield 232228-7W June 7, 2021
Castleman, James F. Delmar 090529-9W June 30, 2021
Corlito, Janette M. Brightwaters C02085-1W June 7, 2021
Davis, Adam Jeffrey Brentwood 176362-2W June 7, 2021
Davis, Richard Gary Huntington 170977-3B June 30, 2021
Derosas, Juan Facundo Lockport 117428-3W June 30, 2021
Dewey, John Cooperstown 200078-4W June 7, 2021
Dimitrov, Nadya E. Smithtown P04243-3W June 7, 2021
Dischiavo, Daniel Arthur New Hartford C05947-9B June 30, 2021
Dsouza, Yvonne Hartsdale 140478-9W June 30, 2021
Edmonston, James Huyette Wellsville 187816-4W June 30, 2021
Eraso, Daniel Ruben Jacksonville 288550-7W June 7, 2021
Federman, Dorothy S. Saranac Lake 123529-0W June 30, 2021
Fischer, Eva Suffern 173175-1W June 30, 2021
Ganesh, Kalyani Syracuse 154862-7W June 30, 2021
Gauger, Barbara Jeanne Williamsville 162651-4W June 30, 2021
Geer, Deborah Ann Auburn 238625-8B June 7, 2021
Geoghean, Richard Matthew Wappingers Falls C03190-8B June 30, 2021
Gibson, Mark Douglas Elmira 145863-7W June 30, 2021
Gold, Alan H. Boca Raton 112760-4W June 7, 2021
Golub, Steven Allen Boynton Beach 151991-7B June 30, 2021
Gowan, Ivan Darius Amelia Island 153105-2W June 7, 2021
Graver, L. Michael New Hyde Park 136870-3W June 30, 2021
Greany, Michael Philip Spring Valley C05515-4B June 30, 2021
Gundy, Edward V. Purchase 131888-0W June 30, 2021
Hannafin, Jo A. New York 172771-8W June 7, 2021
Hart, Shern Trumansburg 124668-5W June 7, 2021
Heelan, Robert Terence Brooklyn 112053-4W June 30, 2021
Hon, John Wingsun Brooklyn 142973-7W June 1, 2021
Isaacson, Steven R. Tenafly 161304-1W June 7, 2021
Kahn, Evelina Lucia Melville 160053-6W June 30, 2021
Kane, Michael Robert Poughkeepsie 230490-5B June 30, 2021
Khalsa, Kunwar Singh Albany 283222-8W June 30, 2021
King, Richard W. Valley Cottage 130834-5W June 30, 2021
Kneib, Jonathan Boyd Stony Brook 289098-6W June 30, 2021
Koser, Mark William Staten Island 169168-2W June 30, 2021
Levine, Allwyn Joseph New York 263078-8B June 30, 2021
Lofaso, Liliana Cayuga 154077-2W June 30, 2021
Madden, Michael Mc Keon Buffalo 093846-4W June 30, 2021
Maharam, Lewis G. New York 169187-2W June 30, 2021
McCall, Charles Louis Jackson 297548-0W June 30, 2021
McHugh, Ellen Margaret Horsehead 165834-3W June 7, 2021
Minzer, Leonard Rockaway Park 085492-7W June 30, 2021
Negron, David Eric Diaz Norwell P05160-8W June 7, 2021
Nichols, Norman Joseph Walnut Creek 076612-1W June 7, 2021
Oh, Chung Hyun Auburn 111469-3W June 30, 2021
Parnell, John Vincent Bay Shore 215008-4W June 30, 2021
Patel, Sureshchandra S. Staten Island 117760-9W June 7, 2021
Paulus, Peter Batavia 206223-0W June 30, 2021
Peters, Nicholas Salvador New Hartford 153507-9W June 30, 2021
Priebe, Cedric J., Jr. Stony Brook 080836-0B June 30, 2021
Prufer, Steven William Forest Hills 118302-9W June 7, 2021
Rand, Stephen P. Cedarhurst 114186-0B June 7, 2021
Raudenbush, Brandon Leroy Novelty 272940-8W June 30, 2021
Rizzuti, Raymond A. Brooklyn 122473-2W June 30, 2021
Roemmelt, Arthur Camillus 106809-7W June 30, 2021
Roofeh, Jahanshah New Hyde Park 144347-2B June 30, 2021
Roth, David Mark Guttenberg 159063-7W June 7, 2021
Sanfilippo, Robert John Chappaqua C08696-9W June 30, 2021
Shephard, Virginia Theresa Hornell 169884-4W June 30, 2021
Siddique, Qazi Asif Williston Park 262133-2W June 30, 2021
Simon, Sheldon Brooklyn 105210-9W June 7, 2021
Smith, Annette Marie Binghamton 218971-0W June 30, 2021
Smith, Roy Anthony Syracuse 138636-6W June 30, 2021
Sung, Janet Hyunsook Williamsville 126004-1W June 30, 2021
Taylor, Philip Grant Brooklyn 095198-8I June 30, 2021
Tumarkin, Freya Rockville Centre S06619-1W June 7, 2021
Vaidya, Dipak Natverlal North Brunswick 185724-2W June 7, 2021
Welch, Michael C. Schenectady 131244-6W June 30, 2021
Welles, Linda Bentz Rochester 244687-0W June 30, 2021
Wolf, Aharon A. Pompano Beach 262821-2W June 1, 2021
Wyluda, Edward John East Syracuse 289014-3W June 30, 2021
Zelanka, Kerry Hewlett C02701-3B June 7, 2021
Zickel, Robert E. Dover Plains 086463-7B June 30, 2021
Zimmerman, Robert DavidNew York118156-9WJune 30, 2021

*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