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Workers' Compensation Board

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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. 046-783

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

Date: July 1, 2015

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
Abdelazim, Mohamad Binghampton 107181-0W April 13, 2015
Arena, Angelo Hannibal 082475-4W April 13, 2015
Arkins, Robert Eli New York 079285-3W April 13, 2015
Aust, John Charles Skaneateles 112368-6W April 13, 2015
Bathrick, Charles Ernest Canandaigua 071291-9W April 13, 2015
Bronster, Stephen Mayer Oceanside S14363-6B April 13, 2015
Burris, Harriet L Alexandria Bay 131476-4W April 13, 2015
Colvin, George Leslie Valley Stream 088008-8B April 13, 2015
Dolan, William Austin Rochester 107414-5W April 13, 2015
Eddy, Donnel B Glens Falls C09775-0B April 13, 2015
Ego, Aguirre Ernesto New York 103051-9W April 13, 2015
Genieser, Nancy Branom New York 094140-1W April 14, 2015
Greco, John Stony Brook 166212-1W April 14, 2015
Filardi, Gregory R Monroe C02000-0B April 14, 2015
Forim, Myron A Woodmere 081376-6W April 14, 2015
Garcia, Andrew Scott Ozone Park C07588-9W April 14, 2015
Huber, Michael Stone Bronx 168086-7B April 14, 2015
Iroku, Humphrey A Bellport 125949-8W April 14, 2015
Josen, Avtar Singh Manhasset 109913-4W April 14, 2015
Kahn, Alvin Jerome New Rochelle 076538-9W April 14, 2015
Kaufer, Marshall Suffern C00178-6W April 14, 2015
Kirshbaum, Michael S West Islip C07571-5W April 14, 2015
Krumpholz, Mark Douglas New Hartford 149754-4W April 14, 2015
Lee, Frances Eun-Hyung Rochester 197920-2W April 14, 2015
Lee, Woon Soon New York 108380-7W April 14, 2015
Lou, Gin Wen Delmar 268043-7W April 14, 2015
Lubetsky, Herman W New York 077813-4W April 14, 2015
Mapara, Hashim Abdulrehman Rome 254499-7W April 14, 2015
Marroquin, Bridget Murphy Rochester 255302-2W April 14, 2015
Nash, Amanda Meagan Albany C11802-8W April 14, 2015
Nour, Mohamed K Whitestone 126616-2B April 14, 2015
Parkinson, David Keith Port Jefferson 168393-7W April 14, 2015
Pearl, Marilyn Great Neck 079626-8W April 14, 2015
Pelebecky, George William Jr Purchase 108908-5W April 14, 2015
Richardson, Matthew L Rochester C12111-3B April 14, 2015
Rosenblum, Saul Auburn 144966-9W April 14, 2015
Ross, Brian Melville C10595-9W April 15, 2015
Rutgers, Carol Fay New York 097582-1W April 15, 2015
Savino, Joseph N Port Washington 089417-0B April 15, 2015
Seguritan, Cesar S Staten Island 134014-0W April 15, 2015
Sewell, Clinton James Cambria Heights 179357-9W April 15, 2015
Shapiro, Howard Brooklyn C02102-4B April 15, 2015
Thissell, Judah Briggs Owego C12115-4W April 15, 2015
Tommasino, Melissa Laura East Setauket C08781-9B April 15, 2015
Wickiewicz, Robert George Valatie 114150-6W April 15, 2015

* 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