Subject Numbers Regarding Health Provider Authorizations

Authorization No. 100441-5W

February 20, 2013

Please be advised that Kamil Mustafa, M.D., has resigned his authorization to treat injured workers in the New York State workers' compensation system effective February 7, 2013. Dr. Mustafa's last known business address is 454 Main Street, Fort Lee, New Jersey, 07024.

Dr. Mustafa is prohibited from rendering treatment and care to injured workers. Reports submitted by Dr. Mustafa for services rendered prior to February 7, 2013, are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Mustafa for services rendered prior to February 7, 2013, should not be denied due to his voluntary resignation.

Any questions regarding the authorized lists should be referred to Health Provider Administration at 1 (800) 781-2362.