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Subject Number 046-1576 October 2022 Removals from the List of Authorized Health Care Providers

Subject Numbers Regarding Health Provider Authorizations

December 21, 2022

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
Mustafa Abdulrahman Farmingville 305591-0W October 28, 2022
Molave A. Adaniel Dix Hills 111104-6W October 28, 2022
Vincent Yao Adofoli New York C12870-2B October 28, 2022
Gregory J. Adornetto Fort Lauderdale P02891-0W October 28, 2022
Keriosv Ammonius Bayside PT037321-7W October 28, 2022
Srilakshmi Atluri New York 276735-8W October 28, 2022
Dustin Baldwin Astoria PT044396-0W October 28, 2022
Eduardo D. Bernales Staten Island 124984-6W October 28, 2022
Paul J. Betschart Danbury P05002-2W October 28, 2022
Shabir Bhayani Olean 172880-7W October 28, 2022
Paul Abraham Bienstock New York 092543-8W October 28, 2022
Matthew J. Boheen Webster C11932-1B October 28, 2022
Philip A. Bonanno Glen Cove 124617-2B October 28, 2022
Michael F. Boyle Leesburg 252288-6W October 28, 2022
John R. Brereton Newport 131008-5W October 28, 2022
Richard F. Brodman Mount Desert 124991-1W October 28, 2022
Samuel Alan Brody Wilmington 153180-5W October 28, 2022
Abby Ilene Budnick East Meadow C05679-6W October 28, 2022
Richard Michael Burg White Plains 111819-9W October 28, 2022
Valentine Jewell Burroughs Nyack 135716-9W October 28, 2022
William A. Busino, Jr. Schenectady 127275-6W October 28, 2022
Jose Antonio Noriega Houston 275168-3W October 28, 2022
Robert Lord Caldwell Scottsville 089585-4W October 28, 2022
Paul James Capobianco Pembroke Pines 199975-4W October 28, 2022
Norbert,Joe Cardoso East Amherst 251785-2W October 28, 2022
Manasi Dhiren Chalishazar Englewood PT041242-9W October 28, 2022
Joseph Leonce Charlot, Jr. Charlotte 272543-0W October 28, 2022
Norman E. Chase New York 078800-0W October 28, 2022
Yuliya Chernyak Staten Island AC003795-2W October 28, 2022
Cheryl Lynn Clark New York 211867-7W October 28, 2022
Gerald L. Corva Garden City C03399-3B October 28, 2022
Dzmitry Dadonau Brooklyn AC006542-5W October 28, 2022
David Paul Dever Las Cruces 146560-8B October 28, 2022
Dominic Peter Di Vincenzo Spencerport 086467-8W October 28, 2022
John S. Dierna Webster C06260-4W October 28, 2022
Guy A. Ditommaso Cape Coral C02498-4W October 28, 2022
Richard B. Dixon East Syracuse C03332-4W October 28, 2022
Robert Michael Domke Carmel 190452-3W October 28, 2022
John Rudolph Drudy Hampton Bays C05327-4W October 28, 2022
Nathaniel Todd Fiedler Troy PT037358-9W October 28, 2022
Daniel Joseph Finn Albany 165751-9W October 28, 2022
Ofelia R. Flores Hartsdale 107550-6W June 11, 2020
Oleg Rafaelovich Fuzaylov Kew Gardens 220254-7B October 28, 2022
Mildred Garcia Port Jefferson 220400-6W October 28, 2022
Shawn Michael Gaston Livingston PT036459-6W October 28, 2022
Riva Goldenberg Brooklyn 258052-0B October 28, 2022
Raja S. Gopalan Fredonia 113439-4W October 28, 2022
Michael H. Gordon New York 120344-7I October 28, 2022
Ronald H. Gottlieb Sarasota 149074-7W October 28, 2022
Mary Grace Guenther Pine City AC006559-9W October 28, 2022
Ashutosh Gupta West Sayville 213960-8W October 28, 2022
Arnold Marc Hertz Cedarhurst P02948-8W October 28, 2022
Kristen Dainton Hilliard Panama City C10454-7W October 28, 2022
Debra Hoolahan Sayville C07215-7B October 28, 2022
Harold L. Husovsky Syracuse 184017-2W October 28, 2022
Sonia W. Hyman New York 092646-9W October 28, 2022
Joseph Cody Ibarra West Hartford PT044432-3W October 28, 2022
Michael Alando Johnson Alleghany 192833-2W October 28, 2022
Lee Andrews Jones Fayetteville 172379-0W October 28, 2022
Roger E. Kaiser, Jr. Chattanooga 142526-3W October 28, 2022
Ciara Anne Kazakis Syracuse 299288-1W October 28, 2022
Michael Francis Keane Palenville PT015479-9W October 28, 2022
Jessica Sheri King Champlain 279899-9W October 28, 2022
Robert A. Klein Jackson Heights P03574-1W October 28, 2022
Joseph J. Kuchinski, Jr. Las Vegas 181586-9B October 28, 2022
Jeon Hoo Lee Cliffside Park 144341-5W October 28, 2022
Louis Young Lee Tenafly 258545-3W October 28, 2022
Cameron Patrick Lewis Yorktown Heights 279427-9W October 28, 2022
Jungjae Lim Syracuse 306010-0W October 28, 2022
Jennifer Pauline Logan Buena Vista 198357-6W October 28, 2022
David M. Lowell West Barnstable 148838-6W October 28, 2022
Akram Hassan Mahmoud Newton 305839-3W October 28, 2022
James V. Manzione Portland 154353-7W October 28, 2022
Jonathan Howard Margolin Teaneck P05602-8W October 28, 2022
Rogelio Avila Martinez San Antonio 251377-8W October 28, 2022
Virginia E. Maurer Mineola 145108-7W October 28, 2022
Terence M. McGarry Pelham 135070-1W October 28, 2022
Aleksandra Zofia Michalik Massapequa 268928-9W October 28, 2022
Jeffrey S. Moretti Staten Island C05849-5W October 28, 2022
Richard T. Moxley, III Cockeysville 120854-5W October 28, 2022
Mark Roy Novick New York 086231-8W October 28, 2022
Anis Ibrahim Obeid Syracuse 100016-5B October 28, 2022
Nicole Marie Obenrader New York PT040717-1W October 28, 2022
Herman Oliver Great Neck 083821-9W October 28, 2022
Ramkumar Panhani Queens Village 199398-9W October 28, 2022
Thomas Arthur Pearson Gainesville 175541-2W October 28, 2022
Robert C. Philips Binghamton P02968-6B October 28, 2022
Sudhir Choudary Potluri Clinton 185337-3W October 28, 2022
Saul Lloyd Presberg Rochester 090588-5W October 28, 2022
J. Gerald Quirk, Jr. Little Rock 124654-5B October 28, 2022
Muhammad Raqib Raja Naples 107595-1W October 28, 2022
Sanford Abraham Ratzan New York 096801-6B October 28, 2022
Leonard Reiffe New York 153515-2W October 28, 2022
Ahmed Mohamed Rezk New Hyde Park 278589-6W October 28, 2022
Fleurgin Rochelin Miami 259771-4W October 28, 2022
Constance Anne Romano Brooklyn P04427-1W October 28, 2022
Ruth Rosenblatt New York 095311-7W October 28, 2022
John K. Rugge, Jr. Chestertown 120486-6W October 28, 2022
Marcus Richard Rusek Forest Hills C04547-6B October 28, 2022
Roger Errol Salisbury Scottsdale 147254-7W October 28, 2022
Huda Sal Stony Brook 280386-4B October 28, 2022
Adam Zion Schayek New Rochelle PT044576-7W October 28, 2022
Melissa Catherine Schroers Roanoke S17369-0W October 28, 2022
Steven Jeremy Schwartz Hewlette 097721-5B October 28, 2022
Nelson Seidman Gainesville C00993-6B October 28, 2022
William John Senisi Poughkeepsie 148468-2W October 28, 2022
Edith Senyumba Hightstown 261485-7W October 28, 2022
Dushyantkumar Kantilal Shah North Reddington Beach 147371-9W October 28, 2022
Catherine Malone Smitas Schenectady 243987-5W October 28, 2022
Glennell Renford Smith Buffalo 198956-5W October 28, 2022
Richard L. Stapen Woodbury 131211-5B October 28, 2022
Irving Sterman Willow Street 094575-8I October 28, 2022
Gregory Paul Stoltzfus Buffalo 298736-0W October 28, 2022
Walter H. Sturm Lake Worth 144461-1W October 28, 2022
Gonzalo Fernandez Urbano Brooklyn 180174-5W October 28, 2022
Sidney O. Veitch New York 128797-8W October 28, 2022
Maureen Meghan Velasco Buffalo PT037101-3W October 28, 2022
Brandon Nicholas Vernon Cortland C13259-7B October 28, 2022
Dana James Vick Englewood 228315-8W October 28, 2022
Kathryn Teresa Vullo North Chili S15139-9B October 28, 2022
Daniel Andrew Weber Elizabethtown PT024435-0W October 28, 2022
Lorne Everd Weeks, III Oneonta 238707-4W October 28, 2022
Andrew Jay Weiland New York 181147-0W October 28, 2022
Judith Weingram New York 092885-3W October 28, 2022
Richard Alan Weiss Saint James 180728-8B October 28, 2022
Akriti Yadav New Hyde Park PT040706-4W October 28, 2022
Christie Hyunsu Yi Tenafly 213161-3W October 28, 2022

*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