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Workers' Compensation Board

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New York State
Workers' Compensation Board
OFFICE OF THE CHAIR
328 State Street  Schenectady, New York 12305
Governor Andrew M. Cuomo


Subject No. 046-1117

Changes to the List of Health Care Providers Authorized to
Render Services to Injured Workers
Under the Workers' Compensation Law

Date: November 14, 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
Amaro, Jaclyn Marie Armonk C12256-6B September 13, 2018
Ang, Howard Yap Perry 165901-0W September 13, 2018
Angelos, Spyros Peter Plattsburgh 090150-4W September 13, 2018
Antony, Ajit I. New Windsor 124967-1W September 13, 2018
Appannagari, Anoop Stony Brook 284360-5W September 13, 2018
Baram, David A. New York 120128-4W September 13, 2018
Bartz, James T. Depew C02040-6W September 13, 2018
Bello, Edward Thomas Milford 070694-5W September 13, 2018
Bello, Osagie San Diego 279503-7W September 13, 2018
Bernstein, Evan Keith Shirley C07674-7W September 13, 2018
Berson, Robert Jeffrey Fort Salonga 118380-5W September 13, 2018
Branson, Brittany Rachel New Haven 284215-1W September 13, 2018
Brietstein, Daniel Lake Success 196998-9W September 13, 2018
Bruckmann, Elana Scarsdale 086114-6W September 13, 2018
Butt, Khalid M. H. Briarcliff Manor 109826-8W September 13, 2018
Canapary, Leon John Rochester 085779-7B September 13, 2018
Choe, Jae Hak Fort Lee 111203-6W September 13, 2018
Chouchani, Gabriel E. Williamsville 117387-1W September 13, 2018
Colletti, Gasper Culver City S06235-6W September 13, 2018
Coppens, Marguerite Louise Williamsville 158086-9W September 13, 2018
Cristello, Thomas Gerard Woodhaven C10107-3B September 13, 2018
Dickinson, Daniel S. Schenectady 251231-7B September 13, 2018
Divan, Kishore Vajendra East Amherst 113383-4W September 13, 2018
Duvall, Michelle Jeanne Rochester 284550-1W September 14, 2018
Fein, Arthur B. Brewster S03655-8W September 14, 2018
Ford, Dawn Saint Charles C04929-8W September 14, 2018
Forschner, Thomas Tiberius Forest Hills 093925-6B September 14, 2018
Frank, Maria A. New Orleans 190354-1W September 14, 2018
Franklin, Peter D. Beachwood 198406-1W September 14, 2018
Garton, Nathan Alan Rochester 284677-2W September 14, 2018
Glazer, Howard I. New York S04694-6W September 14, 2018
Graham, David Hanser Wellsville 128563-4W September 14, 2018
Griffin, John F. San Francisco 108376-5B September 14, 2018
Grodin, Warren K. Valley Cottage 133869-8W September 14, 2018
Hamed, Mikalyn J. North Port C10008-3W September 14, 2018
Hare, Nathan Vestal S05631-7B September 14, 2018
Hasan, Aysha Stony Brook 279601-9W September 14, 2018
Havernick, Nancy Jean Dewitt 159000-9W September 14, 2018
Hershenson, Paul White Plains 085728-4B September 14, 2018
Hertanu, Judith Susan New York 100761-6B September 14, 2018
Hetrick, Jennifer Ellen Pittsford 260281-1W September 14, 2018
Higgins, Elizabeth Anne Baltimore 183455-5W September 14, 2018
Hirsch, Irving A. Highland HGTS 152020-4W September 14, 2018
Hong, Jin Ki Flushing 249920-0W September 14, 2018
Jaski, John Walter Glenville 118189-0W September 14, 2018
Jindal, Vikas Dallas 234486-9B September 14, 2018
Joffe, Sandor Abraham New York 214179-4W September 14, 2018
Juang, Kuo Sheng Bayside 119162-6W September 14, 2018
Kahan, Miles Brooklyn 084255-9W September 14, 2018
Kanter, Norman J. Smithtown S05035-1W September 14, 2018
Karra, Srivani Allentown 241535-4W September 14, 2018
Kasten, Edwin Brooklyn C01873-1B September 14, 2018
Katz, Steven Michael Huntington 193963-6B September 14, 2018
Kepes, Ira J. Rocky Point 168769-8W September 14, 2018
Kern, Matthew Bennett Rockville CTR 261428-7B September 14, 2018
Kerner, Ronald Jon Setauket S11031-2W September 13, 2018
Kibel, Howard David Shrub Oak 092065-2W September 13, 2018
Kim, Jennifer Hee Rockville Centre 277350-5W September 13, 2018
Kunchala, Subbarao Nassau 127971-0W September 13, 2018
Laroche, Eddy Macedon 198048-1W September 13, 2018
Malik, Chetan Morganville 258156-9W September 13, 2018
Marar, Hani George Albany 147273-7W September 13, 2018
Mardakh, Simon Staten Island 269292-9W September 13, 2018
Mc Ginn, Thomas Gregory Staten Island 081315-4W September 13, 2018
Mihail, Radu Clifford Putnam Valley 219275-5W September 13, 2018
Miller, Danielle Leigh Sedona C11402-7B September 14, 2018
Miller, Nicholas Wyatt Delmar 268681-4W September 13, 2018
Mirza, Victoria Miruna Johnson City 232873-0W September 13, 2018
Mohan, Sasikala Englewood 142761-6W September 13, 2018
Nadeau, Ryan Thomas Rochester C12191-5W September 13, 2018
Nandra, Kiritpaul Singh Rochester 284553-5W September 13, 2018
Nguyen, William Brooklyn 194487-5W September 13, 2018
Nozad, Parirokh Old Brookfield 119601-3W September 13, 2018
Nwakanma, Chidinma Crystal Stony Brook 284625-1W September 13, 2018
Oldham, Karen P. Houston 105744-7W September 13, 2018
Onuoha, Uchechukwu N. Allentown 258818-4W September 13, 2018
Packard, R. Andrew Hudson 136954-5W September 13, 2018
Paivanas, Nicholas Andrew Rochester 268392-8W September 13, 2018
Park, Hee M. Goshen 125222-0W September 13, 2018
Pascual, Elsa D. Goshen 144835-6W September 13, 2018
Pastore, Thomas Edward East Aurora 098835-2B September 13, 2018
Penna, Ronald Matthew Farmington 116147-0W September 13, 2018
Rahman, Mohammad Anisur Panama City 213014-4I September 13, 2018
Rayalam, Kiran Reddy Owego 267651-8W September 13, 2018
Rice, Stuart N. Basking Ridge 153516-0W September 13, 2018
Rosen, Michael Joseph Huntington 179918-8W September 14, 2018
Ruotolo, Ronald A. Ormond Reach 104266-2W September 14, 2018
Sauter, Michael Ottmar Port Jefferson 113223-2B September 14, 2018
Sciarrino, Peter C. Erie 149379-0W September 14, 2018
Sekons, David H. Austin 140144-7I September 14, 2018
Shivers, Lawrence Joseph Floral Park 097806-4W September 14, 2018
Shperling, Irena Jericho 141337-6B September 14, 2018
Slaunwhite, W Roy, 3D Saranac Lake 120898-2W September 14, 2018
Spieth, Michael Ernest Marshfield 251629-2W September 14, 2018
Steier, William Forest Hills 081835-1W September 14, 2018
Steinberg, Eugene Allen OKC 138889-1W September 14, 2018
Stiehm, William D. Lighthouse Point 101103-0W September 14, 2018
Sudan Nalin Kumar Manhasset 153137-5W September 14, 2018
Thomas, Jared K. Melbourne 144204-5W September 14, 2018
Thompson, David C. Gloversville S03338-1B September 14, 2018
Tirschwell, Perry Dobbs Ferry 083322-8W September 14, 2018
Tolhurst, Kirk D. Ithaca 162219-0W September 14, 2018
Triner, Wayne Russell Delmar 178217-6W September 14, 2018
Turner, Sophie Selma New York 094077-5W September 14, 2018
Valenca, Mucio Rego Venice 100777-2W September 14, 2018
Ventura, John M. Rochester C03549-5B September 14, 2018
Viswanathan, Prakash East Meadow 250191-4W September 14, 2018
Weinreb, Herbert L. Brooklyn 074909-3W September 14, 2018
Weiss, Laszlo Brooklyn 147169-7W September 14, 2018
Westlake, Robert Elmer, Jr. Syracuse 137940-3B September 14, 2018
Williams, Gary M. Scarsdale 124795-6W September 14, 2018
Zarillo, George Gulfport C03518-0W September 14, 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