Subject Numbers Regarding Health Provider Authorizations
October 9, 2019
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 |
|---|---|---|---|
| Averick, Rauvan Micah | Houston | 154708-2W | August 12, 2019 |
| Baerson, Alanne | New York | S13788-5W | August 12, 2019 |
| Bannon, John David | Queensbury | 136663-2W | August 12, 2019 |
| Baram, Lena Diane | Washington | 189342-9W | August 12, 2019 |
| Barra, Edward Peter | Rochester | P02234-4W | August 12, 2019 |
| Belfiore, Michael Vincent | Merrick | 200906-6W | August 12, 2019 |
| Bernstein, Ira | Bardonia | P05869-4W | August 12, 2019 |
| Bhayani, Hansa Hemant | Tavares | 159382-1W | August 12, 2019 |
| Boras, Stephen | Cairo | C05302-7W | August 12, 2019 |
| Burkley, Brandon Robert | Red Hook | C09296-7W | August 12, 2019 |
| Byrom, David Gene | Commack | S03630-1W | August 12, 2019 |
| Cocioba-Botosan, Smaranda | Ridgewood | 164309-7W | August 12, 2019 |
| Contino, Carl A. | Getzville | 082841-8W | August 12, 2019 |
| Cunningham, Eugene E. | West Seneca | 116171-0W | August 12, 2019 |
| Cuti, Jay Vincent | Huntington | 110864-6W | August 12, 2019 |
| Dale, Robert Charles | Rochester | 106987-1W | August 12, 2019 |
| Deshmukh, Madhav Narayan | Lockport | 158246-9W | August 12, 2019 |
| Dinani, Aliraza Dilawer | Minneapolis | 276058-5W | August 12, 2019 |
| Driscoll, Miles E. | Vacaville | 241582-6W | August 12, 2019 |
| Edelstein, Bernard | Manhasset Hills | 082360-9W | August 12, 2019 |
| Ekholm, Sven E. | Rochester | 153808-1W | August 12, 2019 |
| Emad, Jamal | Barneveld | 093741-7W | August 12, 2019 |
| Firooznia, Hossein | Scarsdale | 109238-6W | August 12, 2019 |
| Freiser, Mark A. | Hollywood | P03084-2W | August 12, 2019 |
| Frymoyer, Carolyn Ledda | Manlius | 137949-4W | August 12, 2019 |
| Jean-Charles, Sashenka | Erlanger | 263588-6w | August 12, 2019 |
| Gallagher, Christopher J. | Stony Brook | 239953-3W | August 12, 2019 |
| Gewacke, Marilyn | Albany | S06617-5W | August 12, 2019 |
| Giuliani, Jeffrey Robert | Auburn | 272468-0W | August 12, 2019 |
| Grauer, Seymour David | Syosset | 085368-9W | August 12, 2019 |
| Green Martin Barry | Boca Raton | C06814-0W | August 12, 2019 |
| Greene, John D. | Lewiston | 126103-1W | August 12, 2019 |
| Gusset, George G. | New York | 086864-6W | August 12, 2019 |
| Herrera, Anibal Pedro | Middletown | 094107-0W | August 12, 2019 |
| Kaplan, Roger | Rocky Point | C01917-6B | August 12, 2019 |
| Lassiter, Tally Edward, Jr. | Cooperstown | 256321-1W | August 12, 2019 |
| Leichman, Cynthia Gail | New York | 209079-3W | August 12, 2019 |
| Lesin, Martin L. | Port St. Lucie | C02056-2W | August 12, 2019 |
| Levine, Martin | Boynton Beach | 086646-7W | August 12, 2019 |
| Lewenberg, Adam | New York | 105605-0W | August 12, 2019 |
| Lines, David Ted | West Seneca | C02578-5W | August 12, 2019 |
| Keyes, John L. | Dunkirk | 129652-4W | August 13, 2019 |
| Korn, Jay L. | New York | 092822-6W | August 13, 2019 |
| Kothari, Mayur J. | Meadow | 145468-5W | August 13, 2019 |
| Landes, Arlene Augusta | New York | S09868-1W | August 13, 2019 |
| Larow, Edward Joseph, Jr. | Plattsburgh | 206341-0W | August 13, 2019 |
| Lascola, Robert John | Buffalo | 098279-3W | August 13, 2019 |
| Martin, Raquel Gertrud | Williamsville | 157556-2W | August 13, 2019 |
| McCarthy, Katherine Ann | Skaneateles | 146570-7W | August 13, 2019 |
| Mcclellan, John Baptiste | Jamestown | 280578-6W | August 13, 2019 |
| Mendel, Julius G. | Great Neck | 079551-8W | August 13, 2019 |
| Menkes, Stephen | Hudson | 103089-9W | August 13, 2019 |
| Minor, John Ellis | Utica | 176034-7W | August 13, 2019 |
| Movaghar, Mansoor | Setauket | 211347-0W | August 13, 2019 |
| Nathan, Annette Raquel | Dayton | 166197-4W | August 13, 2019 |
| Nzuzi, Simon M. | Hollis | P03037-0W | August 13, 2019 |
| Ostovar, Raha | Atlanta | C12827-4W | August 13, 2019 |
| Panitz, Lawrence | Yonkers | 098987-1W | August 13, 2019 |
| Polacek, Daniel Joseph | Fayetteville | 141347-5W | August 13, 2019 |
| Propper, Martin Michael | Great Neck | S03576-6I | August 13, 2019 |
| Prushik, Kenneth Howard | Huntington | 228253-1W | August 13, 2019 |
| Purpura, Anthony Graham | Staten Island | 091283-2W | August 13, 2019 |
| Rock, Samuel Man | Melville | S03905-7W | August 13, 2019 |
| Rodricks, Paul | Sherman Oaks | 198643-9W | August 13, 2019 |
| Roen, Janet L. | New York | 134794-7W | August 13, 2019 |
| Romano, Constance Anne | Brooklyn | P04427-2W | August 13, 2019 |
| Rothenberg, Beanne Oneill | Boulder | S11228-4B | August 13, 2019 |
| Rudolph, Martin Life | Cedarhurst | P02511-5W | August 13, 2019 |
| Sarnowski, Robert J. | Clarks Summit | 263297-4I | August 13, 2019 |
| Schoenfeld, Mark R. | Springfield | 144157-5B | August 13, 2019 |
| Schweitzer, Philip Edward | Bronx | 105455-0W | August 13, 2019 |
| Shah, Surendralal G. | Oster Bay Cove | 133617-1W | August 13, 2019 |
| Song, In Chul | New York | 094064-3W | August 13, 2019 |
| Stasior, Orkan George | Latham | 080808-9W | August 13, 2019 |
| Teitelbaum, Marcel | West Hempstead | S04144-2W | August 13, 2019 |
| Tervo, Kristina Marie | Chittenango | 270560-6W | August 13, 2019 |
| Tiemann, Dawn Dugan | Brooklyn | 291019-8W | August 13, 2019 |
| Travin, Sheldon | Chappaqua | 098358-5W | August 13, 2019 |
| Tuyn, John A. | Williamsville | 087587-2W | August 13, 2019 |
| Vengal, Sarah Ann | Powell | 282091-8W | August 13, 2019 |
| Weber, Carl Paul | White Plains | 093833-2W | August 13, 2019 |
| Wright, Susan Marie | Williamsville | P03344-0W | August 13, 2019 |
| Zambuto, Gerlando | Brooklyn | C12490-1W | August 13, 2019 |
* 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