Subject Numbers Regarding Health Provider Authorizations
June 4, 2018
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 |
|---|---|---|---|
| Asaad, Bassem Onsy | Saint Louis | 256799-8W | April 10, 2018 |
| Aguero, Jose A. | Lynbrook | 135489-3W | April 10, 2018 |
| Bancroft, George Reid | Hamburg | 265999-3W | April 10, 2018 |
| Bazaz, Bansi Lal | Ogdensburg | 108852-5W | April 10, 2018 |
| Beil, Arthur Randall | Port Washington | 085095-8W | April 10, 2018 |
| Bekerus, Zorka | Johnstown | 107636-3W | April 10, 2018 |
| Beligotti, Ronald J. | Watkins Glen | C01927-5W | April 10, 2018 |
| Bell, Bertrand Monroe | New York | 078165-8W | April 10, 2018 |
| Bortolussi, Mario E. | Marco Island | 131003-6W | April 10, 2018 |
| Brouxhon, Sabine | Lexington | 220288-5W | April 10, 2018 |
| Capriotti, Philip E. | Orono | 156992-0W | April 10, 2018 |
| Cheda, Jesus | New York | 091170-1W | April 10, 2018 |
| Cole, Craig Neal | Melbourne | 259340-8W | April 10, 2018 |
| Danziger, Allan | Cliffside Park | 143865-4W | April 10, 2018 |
| Desai, Milind Pradip | Bel Air | 247936-8W | April 10, 2018 |
| Detullio, Daniel James | Wappingers Falls | C12174-1W | April 10, 2018 |
| Dinoff, Arthur | New York | 086117-9W | April 10, 2018 |
| Doane, Peter A. | Auburn | 128386-0W | April 10, 2018 |
| Egner, John George | West Islip | 080692-7W | April 10, 2018 |
| Evans, James Thomas | Bluffton | 105969-0W | April 10, 2018 |
| Farruggio, Paul P. | Port Orange | C11687-3W | April 10, 2018 |
| Fey, John Douglas | Fayetteville | 141280-8W | April 10, 2018 |
| Fischman, Alan S. | Hopewell Junction | 131761-9W | April 10, 2018 |
| Fix, Jeffrey Frederick | Hamburg | C08782-7B | April 10, 2018 |
| Fung, Tat Shing | Amherst | 219492-6W | April 10, 2018 |
| Ganem, Meyer M. | Scarsdale | 097480-8W | April 10, 2018 |
| Gardner, Sheila Fulton | Charlotte | 216989-4W | April 10, 2018 |
| Giantinoto, Anthony | Deer Park | C08691-0W | April 10, 2018 |
| Giometti, Renee Marie | Garnet Valley | 203670-5W | April 10, 2018 |
| Godesky, Mary T. | Red Hook | 099215-6B | April 10, 2018 |
| Grodberg, Jennifer Beth | Brooklyn | 219831-5W | April 10, 2018 |
| Gvardijan, Michael George | Patchogue | 080989-7W | April 10, 2018 |
| Hassan, Mahmoud Abdalla Ahmed | Buffalo | 277111-1W | April 10, 2018 |
| Ho, Andrew Tat-Chuen | Utica | 172375-8W | April 10, 2018 |
| Hochberg, Lisa K. | Brooklyn | 155438-5W | April 10, 2018 |
| Joven, Pedro Galang | Lancaster | 104946-9W | April 10, 2018 |
| Kass, Dan M. | Southport | 164677-7W | April 10, 2018 |
| Kleynerman, Iosif | Brooklyn | 173554-7W | April 10, 2018 |
| Koutelos, Thomas N. | Brooklyn | 190521-5W | April 10, 2018 |
| Lee, Eric | New York | 264765-9B | April 10, 2018 |
| Luzuriaga, Admirado Adolfo F., Jr. | Apo | 217493-6W | April 10, 2018 |
| Malfetano, John H. | Guilderland | 154115-0W | April 10, 2018 |
| Maurello, John M. | Oceanside | C04474-5B | April 10, 2018 |
| Mazur, Michael Thomas | Syracuse | 180257-8W | April 10, 2018 |
| McNeil, Connie Kaye | Yonkers | S14435-2W | April 10, 2018 |
| Monroe, Craig Andrew | Binghamton | 197303-1W | April 10, 2018 |
| Morris, Lori Ann | New Paltz | C05033-8W | April 10, 2018 |
| Moshides, Steven John | East Aurora | 164074-7W | April 10, 2018 |
| Newman, Elizabeth R. | Hinesburg | 283744-1W | April 10, 2018 |
| Ng, Jennifer | New York | 185299-5W | April 10, 2018 |
| Nostrame, Susan Anne | Syracuse | 177043-7W | April 10, 2018 |
| Ovanezian, George | Scarsdale | 100023-1W | April 10, 2018 |
| Palmer, Glenn Michael | Skaneateles | 217078-5W | April 10, 2018 |
| Pandya, Mahendra K. | Staten Island | 110002-3W | April 10, 2018 |
| Parikh, Suryakant | East Islip | 115321-2B | April 10, 2018 |
| Petkov, Theodore Michael | Johnson City | 165516-6W | April 10, 2018 |
| Phelps, Paul Owen | Slingerlands | 276931-3W | April 10, 2018 |
| Ramirez, Alain | Miami Beach | 251828-0B | April 10, 2018 |
| Ramirez-Racelis, Carmela | New York | 155020-1W | April 10, 2018 |
| Recitas, Teofilo P. | Port Washington | 126655-0W | April 10, 2018 |
| Robinson, Peter S. | Jamestown | 119678-1W | April 10, 2018 |
| Russo, Dennis | West Baylon | 154642-3B | April 10, 2018 |
| Sampson, Michael Grant | Stony Brook | 146289-4B | April 10, 2018 |
| Schecter, Arnold J. | Louisville | 115690-W | April 10, 2018 |
| Sehgal, Gautam | Livingston | 140763-4W | April 10, 2018 |
| Senal, Eugene Ira | Mount Kisco | 091734-4W | April 10, 2018 |
| Shah, Pankajlal S. | Almond | 145174-9W | April 10, 2018 |
| Silvers, Fred | Great Neck | 083203-0B | April 10, 2018 |
| Sollecito, Peter William | New Burgh | C05200-3W | April 10, 2018 |
| Sopchak, Andrew Michael | Syracuse | 181054-8W | April 10, 2018 |
| Stratemeier, Michael William | Stony Brook | 219353-0W | April 10, 2018 |
| Zackman, Myron Kent | Hartsdale | 108331-0W | April 10, 2018 |
* 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