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New York State
Workers' Compensation Board
OFFICE OF THE CHAIR
328 State Street  Schenectady, New York 12305
Governor Andrew M. Cuomo


Subject No. 046-694

Changes to the List of Health Care Providers Authorized to
Render Services to Injured Workers
Under the Workers' Compensation Law

Date: June 12, 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
Babe, John J Queensbury 109028-1W April 11, 2014
Barrau, Lionel P Glen Cove 114445-0W April 11, 2014
Bulger, Jennifer Leigh Hamburg C11965-3B April 11, 2014
Burman, William Davies Monroe 169163-3W April 11, 2014
Clough, David V Gloversville 090253-6W April 11, 2014
De Cann, Tonya J Newark C11127-0W April 11, 2014
Durrani, Shakeel Farrukh Horseheads 256019-1W April 11, 2014
Giusti, Claire Monroe C03599-0W April 11, 2014
Gold, Marthe Rachael New York 147128-3W April 11, 2014
Goodman, Barry Jay Island Park C05343-1W April 11, 2014
Gross, Richard Eton Westbury C07621-8B April 11, 2014
Heikal, Mohamed O Fayetteville 263679-3W April 11, 2014
Jampol, Jason Adam Port Jefferson Station C09383-3W April 11, 2014
Kane, Neal David Nyack 166569-4W April 11, 2014
Krafte, Burton O Philmont 083787-2W April 11, 2014
Kuri, John Anthony Massapequa 247323-9W April 11, 2014
Lee, Chong T Vestal 128642-6W April 11, 2014
Leeson, Susan Hume Syracuse 159863-0W April 11, 2014
Lochner, Jon C La Fayette 127712-8W April 11, 2014
Mahon, William A Oswego 142323-5B April 11, 2014
Mehalic, Theodore C New Hartford 125181-8W April 11, 2014
Novak, Michael Peter Schenectady 090885-5W April 11, 2014
Raggi, Robert P New York 143564-3W April 11, 2014
Revzin, Margarita V Brooklyn 247710-7B April 11, 2014
Rivers, Margaret Macdougall Syracuse 211881-8W April 11, 2014
Robin, Murray Babylon 071603-5W April 11, 2014
Ross, Stanley Great Neck 082217-1B April 11, 2014
Setton, Haym Victor Bayside 110194-8W April 11, 2014
Shafer, Nathaniel New York 076953-9B April 11, 2014
Tan, Conchita Orchard Park 117914-2W April 11, 2014
Tepper, Judith Presberg Chappaqua 176748-2W April 11, 2014
Palanisamy, Viswakumar Slate Hill 139336-2W April 11, 2014
Weil, Inga F Beechhurst 047336-3W April 11, 2014
Wells, Richard J Syracuse 092865-5W April 11, 2014
White, Bruce D Mahopac 129065-9W April 11, 2014
Wigdor, Aaron A Port Jefferson 088103-7W April 11, 2014
Wright, Megan Patricia Saranac Lake 233069-4W April 11, 2014
Yarwood, Edwin Howard Liverpool 089451-9W April 11, 2014

* 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