Subject Numbers Regarding Health Provider Authorizations
February 7, 2014
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 |
|---|---|---|---|
| Abdelwahab, Ibrahim | Forest Hills, NY | 133787-2W | November 8, 2013 |
| Allan, David | Durham, NY | P04053-6W | November 8, 2013 |
| Bessette, Russell | Orchard Park, NY | 130805-5W | November 8, 2013 |
| Beyers, Milton | Bay Shore, NY | 047283-7W | November 8, 2013 |
| Bhandarkar, Gopal | Bayport, NY | 109010-9W | November 8, 2013 |
| Birkett, David | Suffern, NY | 105902-1I | November 8, 2013 |
| Bushansky, Abe | Rego Park, NY | P04994-1B | November 8, 2013 |
| Cassara, Ronald | Peconic, NY | 143023-0W | November 8, 2013 |
| Cohen, Arnold | White Plains, NY | 078664-0W | November 8, 2013 |
| Coryllos, Elizabeth | Glen Head, NY | 073989-6W | November 8, 2013 |
| Dahill, Barbara | Grand Island, NY | C07454-4W | November 8, 2013 |
| Danner, Antoinette | Brooklyn, NY | C06382-8W | November 8, 2013 |
| Desai, Apeksha | Rochester, NY | L03094-0W | November 8, 2013 |
| D’sa, Peter | Out of State | 170734-8W | November 8, 2013 |
| Frahman, Frank | East Hills, NY | 105757-9W | November 8, 2013 |
| Frenkel, Richard | White Plains, NY | 093189-9W | November 8, 2013 |
| Garofalo, Ferdinand | Brooklyn, NY | 085439-8W | November 8, 2013 |
| Gessner, William | Kingston, NY | 156643-9W | November 8, 2013 |
| Guarneri, Victor | Bayside, NY | 042384-8W | November 8, 2013 |
| Hadpawat, Narendra | Lawrence, NY | 135196-4W | November 8, 2013 |
| Heise, Carl | Chappaqua, NY | 185547-7B | November 8, 2013 |
| Hobika, John | New Hartford, NY | 078883-6W | November 8, 2013 |
| Hu, Youjun | Stony Brook, NY | 218550-2W | November 8, 2013 |
| Kanski, James | Eggertsville, NY | 086275-5W | November 8, 2013 |
| Khanna, Rajan | Syracuse, NY | L03842-2W | November 8, 2013 |
| Kirkland, Elizabeth | Bayport, NY | C08302-4W | November 8, 2013 |
| Koo, Young | Endwell, NY | 125135-4W | November 8, 2013 |
| Kuthuru, Mahesh | Fulton, NY | 215662-8W | November 8, 2013 |
| Laucella, Anthony | Bayside, NY | 091828-4W | November 8, 2013 |
| Lewis, Leon | Williamsville, NY | 096898-2B | November 8, 2013 |
| Luntz, Maurice | New York, NY | 133478-8W | November 8, 2013 |
| Mason, Susan | Alfred, NY | 254950-9W | November 8, 2013 |
| Mendonza, Ronald | Orchard Park, NY | 128133-6W | November 12, 2013 |
| Menichello, Monica | Owego, NY | 245688-7W | November 12, 2013 |
| Munczek, Debora | New York, NY | S12924-7W | November 12, 2013 |
| Nailor, John | New York, NY | 124754-3W | November 12, 2013 |
| Nurenberg, Jeffry | Pomona, NY | 106141-5W | November 12, 2013 |
| Ogbonna, Justin | Kingston, NY | P06374-4W | November 12, 2013 |
| Oktay, Asian | New York, NY | 103099-8W | November 12, 2013 |
| Osborne, Thomas | Endwell, NY | 248823-7W | November 12, 2013 |
| Parikh, Suresh W. | Seneca, NY | 145098-0W | November 12, 2013 |
| Randall, Patricia | Fayetteville, NY | 123800-5W | November 12, 2013 |
| Rasweiler, Calvin | Garden City, NY | 070304-1W | November 12, 2013 |
| Rivera, Abraham | Tampa, FL | 192496-8I | November 12, 2013 |
| Penfield, John | Vestal, NY | 218868-8W | November 12, 2013 |
| Picinich, Suzanne | Williamsville, NY | 174681-7W | November 12, 2013 |
| Poursartip, Maryam | Brooklyn, NY | L03535-2B | November 12, 2013 |
| Sands, Donna | Out of State | C10501-7B | November 12, 2013 |
| Sangosanya, Abolaji | Out of State | 123460-8W | November 12, 2013 |
| Schonfeld, Wendy | Out of State | C06103-8W | November 12, 2013 |
| Sillars, David | Out of State | 131203-2W | November 12, 2013 |
| Stefanelli, Danette | Out of State | C08653-0W | November 12, 2013 |
| Stein, Michael | Hauppauge, NY | 128067-6W | November 12, 2013 |
| Tahera, Syeda | Middletown, NY | 119485-1W | November 12, 2013 |
| Tetro, Rocco | New York, NY | C09486-4W | November 12, 2013 |
| Torzewski, Erin | New York, NY | C11528-9W | November 12, 2013 |
| Wagner, Daniel | Out of State | S17505-9B | November 12, 2013 |
| Concoby, Dennis | Johnson City, NY | 226295-4W | November 18, 2013 |
| McCarville, Michael | Vestal, NY | 172189-3W | December 2, 2013 |
| Redmond, Stephen | Out of State | 111871-0W | December 4, 2013 |
| Ahmed, Niaz | Loudonville, NY | 141562-9W | December 9, 2013 |
| Attia, Hosam | Slingerlands, NY | 254811-3W | December 9, 2013 |
| Azmoon, Shahdad | Mount Kisco, NY | 247114-2I | December 9, 2013 |
| Baldwin, Frank | Ithaca, NY | 086992-5W | December 9, 2013 |
| Beavers, Russell | Huntington, NY | 135433-1W | December 9, 2013 |
| Bell, James | Penn Yan, NY | 202333-1W | December 9, 2013 |
| Bello, Eric | East Greenbush, NY | 138828-9W | December 9, 2013 |
| Blum, Gerald | New York, NY | 081000-2W | December 9, 2013 |
| Chiavetta-Grisanti, Jennifer | Lockport, NY | C10990-2B | December 9, 2013 |
| Colancecco, Michael | Stony Brook, NY | 262592-9W | December 9, 2013 |
| Datta, Pranab | Vestal, NY | 125035-6W | December 9, 2013 |
| DelGaizo, Christine | Out of State | 143264-0W | December 9, 2013 |
| Desai, Kinnari | New York, NY | 249938-2W | December 9, 2013 |
| Dick, Bruce | Out of State | 172009-3B | December 9, 2013 |
| Drusano, George | Latham, NY | 195525-1W | December 9, 2013 |
| Figueira, Theresa | New York, NY | 078700-2W | December 9, 2013 |
| Flink, Elisheva | Out of State | 201650-9B | December 9, 2013 |
| Green, Douglas | East Corning, NY | 262517-6W | December 9, 2013 |
| Gregory, Daniel | Cooperstown, NY | 183012-4W | December 9, 2013 |
| Griboff, Solomon | Long Beach, NY | 071565-6W | December 9, 2013 |
| Gruis, Kirsten | Out of State | 263856-7W | December 9, 2013 |
| Hall, Alexandra | Ithaca, NY | 233457-1W | December 9, 2013 |
| Hanache, Marie | Old Westbury, NY | 081189-3W | December 9, 2013 |
| Hay, Roger | Out of State | 239398-1W | December 9, 2013 |
| Hayes, Joseph | Out of State | 159224-5W | December 9, 2013 |
| Holmblad, James | Schenectady, NY | 072960-8B | December 9, 2013 |
| Johnson, Jennifer | Stony Brook, NY | 216261-8W | December 9, 2013 |
| Kardooni, Kaveh | Out of State | 257031-5W | December 9, 2013 |
| Kavoussi, James | Brooklyn, NY | 079931-2W | December 9, 2013 |
| Koeppel, Richard | Easthampton, NY | 090546-3W | December 9, 2013 |
| Kohan, Silviu | New York, NY | 118617-0W | December 9, 2013 |
| Labanowski, Mary | Rochester, NY | 158798-9W | December 9, 2013 |
| Lin, Michael | E. Amherst, NY | 151023-9W | December 9, 2013 |
| Livingston, John | Out of State | 101250-9W | December 9, 2013 |
| Losoponkul, Sawat | Williston Park, NY | 127955-3W | December 9, 2013 |
| Mahoney, Dennis | Bridgeport, NY | 128198-9W | December 9, 2013 |
| Milek, Debra | New York, NY | 167248-4B | December 9, 2013 |
| Nguyen, Loan | Staten Island, NY | 239907-9W | December 9, 2013 |
| Ouellette, Thomas | Out of State | C09148-0B | December 9, 2013 |
| Park, Thomas | Rochester, NY | 239926-9W | December 9, 2013 |
| Peeling, Lissa | Out of State | L03863-8W | December 9, 2013 |
| Philip, Leena | Mohegan Lake, NY | 225325-0B | December 9, 2013 |
| Proner, Jacqueline | Flushing, NY | 184953-8W | December 9, 2013 |
| Ramirez, Reinier | Out of State | 202453-7W | December 9, 2013 |
| Rivelloi, Christa | Albany, NY | C05444-7W | December 9, 2013 |
| Rousta, Mehdi | Staten Island, NY | 125645-2W | December 9, 2013 |
| Lax Salton, William | New York, NY | S11620-2B | December 9, 2013 |
| San Pedro, Carmelita | Rochester, NY | 115390-7W | December 9, 2013 |
| Schlageter, David | Rochester, NY | 101885-2W | December 9, 2013 |
| Shah, Shilpan | Stony Brook, NY | 255533-2W | December 9, 2013 |
| Shankar, Ravi | Out of State | 232914-2W | December 9, 2013 |
| Sheehy, Audrey-Jean | Brooklyn, NY | 093167-5W | December 9, 2013 |
| Silberberg, Nathaniel | Out of State | 147186-1W | December 9, 2013 |
| Singh, Anil | Watertown, NY | L03624-4W | December 9, 2013 |
| Stabile, Thomas | Commack, NY | C09458-3W | December 9, 2013 |
| Trout, Adriane | Macedon, NY | 239668-7W | December 9, 2013 |
| Yuzak, Dodanli | Out of State | 189780-0W | December 9, 2013 |
* Providers authorized to treat only, have an authorization number ending in "W" – Providers authorized to treat and perform independent medical examinations, have an authorization number ending in "B" – Providers authorized to perform independent medical examinations only, 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.
Robert E. Beloten
Chair