Subject Numbers Regarding Health Provider Authorizations

Authorization No. 213986-3W

October 1, 2013

Please be advised that Dr. Charles Fisch has resigned his authorization to treat injured workers in the New York State workers' compensation system effective September 27, 2013. Dr. Fisch's last known practice address is 58 Hamlet Drive, Mount Sinai, New York 11766.

Dr. Fisch is prohibited from rendering treatment and care to injured workers. Reports submitted by Dr. Fisch for services rendered prior to September 27, 2013, are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Fisch for services rendered prior to September 27, 2013 should not be denied due to his resignation.

Any questions regarding the authorized lists should be referred to the Medical Director's Office at 1 (800) 781-2362.