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Subject Number 046-1148 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

March 11, 2019

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
Pascarelli, Emil Santa Monica 084851-5W January 2, 2019
Pope, David Farrington Asheville 195014-6W January 2, 2019
Powell, Edward N. Watertown 165818-6W January 2, 2019
Quash, Eugene T. New York 046992-4W January 2, 2019
Accettola, Albert B., Jr. Staten Island 126387-0W January 15, 2019
Basovich, Leonid Miller Place 235997-4W January 15, 2019
Bauer, Ronald Lawrence Fountain Hills 188498-0W January 15, 2019
Bendeth, Marc L. North Woodmere P02369-8W January 15, 2019
Bennett, Michael Huntington Station S07916-0W January 15, 2019
Bensman, Michael S. West Nyack 109279-0W January 15, 2019
Berke, Joseph H. London 094428-0W January 15, 2019
Blackburn, Chame Curtis Albany 237019-5W January 15, 2019
Bonanno, Anthony Windermere 167355-7W January 15, 2019
Brosnan, John Osprey 170214-1W January 15, 2019
Buxbaum, Frederick David Delray Beach P02489-4W January 15, 2019
Caporaso, Anthony M. East Greenwich 235784-6W January 15, 2019
Cataquet, David Maplewood 175359-9W January 15, 2019
Charles, Hearns Wilfrid Miami 189390-8W January 15, 2019
Chhangani, Sanjeev Vijairaj Pointe Vedra Beach 203774-5W January 15, 2019
Cohen, Dale I. Championsgate C02716-1W January 15, 2019
Cohen, Theodore Norman New York 082560-4W January 15, 2019
Derosa, Frank V. Ozone Park C03072-8W January 15, 2019
Dewar, John E. Potsdam 139252-1W January 15, 2019
Dikengil, Asim Gultekin Lyndhurst 165991-1W January 15, 2019
Doreste, William Charles Elmhurst C04449-5W January 15, 2019
Endo, Lawrence Paul Ithaca 166809-4W January 15, 2019
Ferdinando, Edward J. Staten Island P03558-5W January 15, 2019
Faverio, Charles David, Jr. Poughkeepsie 081833-6W January 15, 2019
Gao, Ping Anderson 242214-1B January 15, 2019
Giacalone, Peter Michael Moriches C00802-5W January 15, 2019
Goldman, Amy B. New York 109449-9W January 15, 2019
Goldstein, Mervyn Leon Rockville 086816-6W January 15, 2019
Guralnick, Susan Mineola 172661-1W January 15, 2019
Hart, Brian K. Saranac Lake 159314-4W January 15, 2019
Herbsman, Horace Roslyn Heights 075328-5W January 15, 2019
Higgins, Annlouise Maria Norwood 205544-0W January 15, 2019
Holland, William Augustine Tampa C08934-4W January 15, 2019
Holland-Yang, Amanda Portland 253443-6W January 15, 2019
Hsu, Cher Young Whitestone 090602-4W January 15, 2019
Hu, Qi Hicksville 198501-9W January 15, 2019
Huston, Jason Michael Champaign 269667-2W January 15, 2019
John, Liju Skaria Syracuse 287533-4W January 15, 2019
Jones, Kristina New York 234829-0W January 15, 2019
Joseph, Ashly Elizabeth McDonough 269021-2W January 15, 2019
Kang, Minsoo Williamsville 252105-2W January 15, 2019
Klayman, David Marshall Blauvelt C08738-9B January 15, 2019
Krawchenko, John Watertown 106875-8W January 15, 2019
Kudagi, Vinod Shrishail Bethlehem 254755-2W January 15, 2019
Kunkle, Herbert L. Auburn 270411-2W January 15, 2019
Lanoil, Jerry White Plains S04753-0W January 15, 2019
Lawrence, Andrea Delray Beach C06693-8W January 15, 2019
Lederman, Selwyn New York S03150-0W January 15, 2019
Leilabadi, Shahriyar Akhavan Redmond 242080-0W January 15, 2019
Lin, Jen H. Hicksville 103573-2W January 15, 2019
Malchar, Victoria E. Warwick C02799-7W January 15, 2019
Malossi, Jennifer Binghamton 228628-4W January 15, 2019
Manderson, Lawton Vincent Bellmore 076842-4W January 15, 2019
Markowitz, Jeffrey Woodmere C04415-8W January 15, 2019
Masters, Stanley Floral Park 049013-6W January 15, 2019
Matteo, Richard Seaton Dobbs Ferry 078633-5W January 15, 2019
Mc Clung, James Elliott Goshen 100263-3W January 15, 2019
Mejia, Gustavo A. Lake Grove C03936-4W January 15, 2019
Miller, Donald Ellsworth Orchard Park 101374-7W January 15, 2019
Muia, Nicola Huntington 096191-2W January 15, 2019
Mukherjee, Ratnakar          Columbia 229947-7W January 15, 2019
Murphy, Michael V. Ormond Beach 120744-8W January 15, 2019
Nagasawa, Glen Katsuto Dayton 156198-4W January 15, 2019
Nainzadeh, Nahid K. New York 127256-6W January 15, 2019
Nguyen, Hung Dang Woodcliff Lake 149271-9W January 15, 2019
Nissman, Paul Dobbs Ferry C05886-9W January 15, 2019
Pallotta, John Anthony Bay Shore 078336-5W January 15, 2019
Papciak, Anthony S. Morganton S08834-4W January 15, 2019
Parvin, Ahmad Castle Point 156221-4W January 15, 2019
Pearson, David Bruce Palm Coast C04435-6B January 15, 2019
Pletka, Joshua David East Syracuse 260397-5W January 15, 2019
Podesta, Luga East Setauket 164348-5W January 15, 2019
Pressman, Alan H. Ossining C01286-6W January 15, 2019
Reda, Edward Francis Tarrytown 149688-4W January 15, 2019
Reisel, Arthur Goshen S06734-8W January 15, 2019
Rotman, Marvin Zelman Palm Beach Gardens 087452-9W January 16, 2019
Ross, Jeffrey Stuart Albany 179400-7W January 16, 2019
Rosas, Donovan Thomas Edgar Pomona 262423-7W January 16, 2019
Roehmholdt, Mary Elizabeth Williamsville 128036-1W January 16, 2019
Shah, Pratima M. Rochester 130188-6W January 16, 2019
Schreck, Michael J. Auburn 148459-1W January 16, 2019
Sande, Hervey Allen Brooklyn P02169-2W January 16, 2019
Samios, George Konstantine New York 087199-6W January 16, 2019
Sagalla, Nicole Andrea Stony Brook 270091-2W January 16, 2019
Seplowitz, Alan Harvey Scarsdale 117073-7W January 16, 2019
Shapiro, Jack M. East Northport 140155-3W January 16, 2019
Shaw, Vijay K. Woodmere 142806-9W January 16, 2019
Spiera, Harry New York 082569-5W January 16, 2019
Stoller, Gerald Saul Port Jefferson 099090-3W January 16, 2019
Swiantek, Philip Arthur Buffalo 108820-3W January 16, 2019
Taddeo, Ronald J. Tarpon Springs 123293-3W January 16, 2019
Teitelbaum, Alan R. New York P02880-4W January 16, 2019
Therattil, Maya Rose Skillman 226794-6B January 16, 2019
Tress, Herschel Glenmont 154260-4W January 16, 2019
Ullman, David Alan Cooperstown 161907-1W January 16, 2019
Vedovato, Sandra Lee Fredonia S10437-2W January 16, 2019
Wolstein, Peter D. Bronx P02796-2W January 16, 2019
Woo, Jung John Vienna 222354-3W January 15, 2019
Wu, Duoping_ Paramus 214495-4W January 15, 2019
Pober, Joseph M. New York 144489-2W January 22, 2019

* 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