Subject Numbers Regarding Health Provider Authorizations
July 28, 2022
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 |
|---|---|---|---|
| Adler, Robert Ira | Lady Lake | 098881-6W | May 18, 2022 |
| Agopovich, Arsenio | Troy | 081390-7W | May 18, 2022 |
| Akhtar, Amina | Waldorf | 156421-0W | May 18, 2022 |
| Allard, Felicia D. | Little Rock | 305132-3W | May 18, 2022 |
| Babu, Tara Manyam | Bellevue | 260538-4W | May 18, 2022 |
| Bansal, Nidhi | S. Abington Township | 278315-7W | May 18, 2022 |
| Bartoszek, David M. | Spotsylvania | 161389-2W | May 18, 2022 |
| Bass, Douglas H. | New York | 165753-5W | May 18, 2022 |
| Bierstock, Samuel Richard | Delray Beach | 130657-0W | May 18, 2022 |
| Blum, Isaac | Scarsdale | 111159-0W | May 18, 2022 |
| Boon, Robert C. | Brockport | 089959-1W | May 18, 2022 |
| Boudreau, William James | Norwich | 186378-6W | May 18, 2022 |
| Braga, Jose N. | Hyde Park | 109820-1W | May 18, 2022 |
| Braver, Alexander | Manalapan | 199890-5W | May 18, 2022 |
| Broad, Robert Daniel | Bridgeport | S04164-0W | May 18, 2022 |
| Bromberg, Beth Shapiro | Stamford | 164082-0W | May 18, 2022 |
| Burke, Chris Stephen | Rochester | 248708-0W | May 18, 2022 |
| Cameron, Airlie Ann Carruthers | Bronxeville | 089903-9W | May 19, 2022 |
| Carlucci, Leonard Anthony | Jersey City | C02839-9W | May 19, 2022 |
| Carter Maurice C | New York | 089267-9W | May 19, 2022 |
| Chang Howard | Arverne | 296636-4W | May 19, 2022 |
| Chernilas, Joseph Z. | New York | 158058-8W | May 23, 2022 |
| Chin, Yin Lee | Lindenhurst | 121401-4W | May 19, 2022 |
| Crea, Maria Antoinette | Lewiston | 081018-4W | May 19, 2022 |
| Crowther, John Christian | Longboat Key | 097191-1W | May 19, 2022 |
| Curtis, Theodore Hertzel | Mount Kisco | 259317-6W | May 23, 2022 |
| Deipolyi, Amy | New York | 274375-5W | May 19, 2022 |
| Delamarter, Tara Marie | Vestal | PA019975-2W | May 19, 2022 |
| Dunton, Robert Frederick | Lake George | 242934-8W | May 19, 2022 |
| Evangelista, Jonald Boyles | Southgate | PT032653-8W | May 19, 2022 |
| Fazio, John Raymond | Georgetown | 191793-9W | May 19, 2022 |
| Fishbein, Gerald M. | Fairlawn | S02293-9W | May 19, 2022 |
| Frank, Judith May | Goshen | 104527-7W | May 19, 2022 |
| Fujimura, Osamu | Los Angeles | 216984-5W | May 19, 2022 |
| Gandhi, Krishnakumari | New York | 145265-5W | May 19, 2022 |
| Gordon, Steven Wittenberg | Overland Park | 189397-3W | May 19, 2022 |
| Grand, Sheldon Allen | Delmar | S02845-6W | May 19, 2022 |
| Graziano, Jessica M. | Pearl River | PT029948-7W | May 19, 2022 |
| Hackett, Charles Peter | Point Lookout | 163238-9W | May 19, 2022 |
| Hallac, Ismet | Williamsville | 098249-6W | May 19, 2022 |
| Hammer, Joseph | New York | S10348-1W | May 19, 2022 |
| Harryman, Robert M. | Watertown | 158390-5W | May 19, 2022 |
| He, Lan | Forest Hill | 210578-1W | May 19, 2022 |
| Hollander, Chelsea Michelle | Mount Kisco | 257313-7W | May 19, 2022 |
| Hossain, Mohammed Saha-Adat | Patchogue | 118034-8W | May 19, 2022 |
| Ian, Diorio James Anthony | Cooperstown | C01606-3W | May 19, 2022 |
| Johnston, Mark R. | Syracuse | 149047-3W | May 19, 2022 |
| Katz, Brian E. | Spring Valley | C00848-2W | May 19, 2022 |
| Kaufman, Andrew Greg | Newark | 180253-7W | May 19, 2022 |
| Korrol, Charles Reuben | Piermont | 095661-5W | May 19, 2022 |
| Kostakoglu, Shields Lale | New York | 209952-1W | May 19, 2022 |
| Kumar, Rajesh | Vestal | 284837-2W | May 19, 2022 |
| La Vine, James Joseph | Baldwin | 080270-2W | May 23, 2022 |
| Lehman, Martin A. | West Hempstead | 082928-3W | May 23, 2022 |
| Leistner, Ken E. | East Rockaway | C02576-4W | May 23, 2022 |
| Liu, Hsien Kwang | Staten Island | 114090-4W | May 23, 2022 |
| Lobbia, Loretta E. | Liverpool | S08837-7W | May 23, 2022 |
| Mancke, Brian David | Bronx | 302746-5B | May 23, 2022 |
| Mattei-Gonzalez, Gabriel | New York | 286142-5W | May 23, 2022 |
| Mehta, Shruti Kirti | Columbia | PT044037-0W | May 23, 2022 |
| Meyerberg, Alan | Staten Island | P03274-4W | May 23, 2022 |
| Meyers, Bernard Lawrence | Schenectady | 081160-4W | May 23, 2022 |
| Millmond, Steven Harris | Peoria | 192057-8W | May 23, 2022 |
| Mukhtyar, Dilip Ratilal | Bronx | 111790-8W | May 23, 2022 |
| Murphy, Marilyn Diane | Syracuse | S10982-7W | May 23, 2022 |
| Neuschatz, Joseph J. | Port Jefferson | 091849-0W | May 23, 2022 |
| Patel, Bipinchandra R. | Johns Creek | 137389-3W | May 23, 2022 |
| Patel, Hasmukh P. | Bayport | 125226-1W | May 23, 2022 |
| Patel, Jayant P. | Flushing | 157572-9W | May 23, 2022 |
| Patel, Kriya Balvant | Jersey City | 285245-7B | May 23, 2022 |
| Patel, Rajendrakumar M. | Warsaw | 151555-0W | May 23, 2022 |
| Perillo, Joseph Thomas | Geneva | P03480-1W | May 25, 2022 |
| Saadvandi, Terence M. | Netuchen | P05475-9W | May 25, 2022 |
| Schlifstein, Todd Russell | New York | 205272-8B | May 25, 2022 |
| Schlossberg, Harvey | Forest Hills | S04834-8W | May 25, 2022 |
| Shahin, Naji Abi | Brooklyn | 117258-4W | May 25, 2022 |
| Shapiro, Kenneth S. | East Hampton | 127358-0W | May 25, 2022 |
| Sheikh, Mushtaq A. | Elmira | 120820-6W | May 25, 2022 |
| Sherry, Richard G. | Watertown | 126687-3W | May 25, 2022 |
| Shinohara, Sachiko | Yonkers | PT032532-4W | May 25, 2022 |
| Slotwiner, Paul | New York | 091563-7W | May 25, 2022 |
| Smith, Brittany | Brooklyn | PT044059-4W | May 25, 2022 |
| Spavento, Perry Joseph Carl | Norwich | 166084-4W | May 25, 2022 |
| Stamm, David B. | Poughkeepsie | P03132-8W | May 25, 2022 |
| Stern, Leon | Boca Raton | 142944-8W | May 25, 2022 |
| Stewart, Maxine Claudia | Gilbert | C12374-5W | May 25, 2022 |
| Suarez, Manuel Domingo | Fort Myers | 206844-3W | May 25, 2022 |
| Sweet, Richard David | Purchase | 103167-3W | May 25, 2022 |
| Thota, Srinivasa Sarvabhouma | Newburg | 268939-6W | May 25, 2022 |
| Turcotte, Jan K. | Watertown | 143676-5W | May 25, 2022 |
| Varma, Chelikani V. P. | Depew | 133009-1W | May 25, 2022 |
| Velasquez, David | Brooklyn | 294615-0W | May 25, 2022 |
| Veress, Frank | Morrisonville | 093375-4W | May 25, 2022 |
| Warski, Patricia Lynn | Norwich | P03819-0W | May 25, 2022 |
| Wasserman, Michael A. | New York | C03023-9W | May 25, 2022 |
| Weinstein, Mark Jeffrey | Bethpage | 141364-0W | May 25, 2022 |
| Wellington, Louis | Roslyn | 095619-3W | May 25, 2022 |
| White, Patricia Anne | Basking Ridge | 160317-4W | May 25, 2022 |
| Wiesenfeld, Rachel | Forest Hills | PT044283-0W | May 25, 2022 |
| Wilett, Jerome Rene | Fayetteville | S05499-9W | May 25, 2022 |
| Wilson, Michael F. | Buffalo | 187615-0W | May 25, 2022 |
| Wosnitzer, Brian Edward | Kew Gardens | 266100-7W | May 25, 2022 |
| Zeman, Bethann Marie | Hurley | PA023220-7W | May 25, 2022 |
| Zhao, Alexander | Livingston | PT044048-7W | May 25, 2022 |
| Zhavoronkov, Ilya G. | Rochester | 212591-2W | May 25, 2022 |
| Zikry, Yasser Saad | Jamesville | 172235-4W | May 25, 2022 |
*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