Subject Numbers Regarding Health Provider Authorizations
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