Subject Numbers Regarding Health Provider Authorizations
July 15, 2016
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 |
|---|---|---|---|
| Ahn, Janet H. | Latham | 199135-5W | May 16, 2016 |
| Bartholomew, Jeremy Lynn | Waterville | C10937-3W | May 16, 2016 |
| Beatty, Christopher James | East Setauket | 101612-0W | May 16, 2016 |
| Bell, James B. | Queensbury | 076415-9W | May 16, 2016 |
| Berenberg, Martin | Quogue | S05885-9B | May 16, 2016 |
| Bhasin, Jatinder | Plattsburgh | 220303-2W | May 2, 2016 |
| Casas, Luis F. | Franklin Square | 126430-8W | May 16, 2016 |
| Chun, Kyung S. | Slingerlands | 121422-0W | May 16, 2016 |
| Clarke, Edward H. | Lowman | 103999-9W | May 16, 2016 |
| Clarkin-Dedio, Kathleen Carey | Prescott Valley | C11437-3W | May 16, 2016 |
| Collins, Robert L. | Plattsburgh | 129895-9W | May 16, 2016 |
| Colose, Lynne Marie | Niskayuna | C07791-9W | May 16, 2016 |
| Cooke, Randolph Boyd | Owego | 116682-6W | May 16, 2016 |
| D'Arcy, Christopher G. | Liverpool | C10000-0B | May 16, 2016 |
| Deiorio, Anthony V. | Delray Beach | 09323-0W | May 16, 2016 |
| Demas, Christopher Papalexis | Staten Island | 257352-5B | May 16, 2016 |
| Fedak, Michael Joseph | Boca Raton | 134691-5W | May 16, 2016 |
| Fernaine, Antoine V. | Brooklyn | 122899-8B | May 16, 2016 |
| Foglia, Christopher Thomas | Bohemia | C07116-9B | May 17, 2016 |
| Gallina, Michael John | Poughquag | P03662-5B | May 17, 2016 |
| Goldman, George D. | New York | S00694-0W | May 17, 2016 |
| Fiore, Americo S. | Stony Brook | 095689-6W | May 17, 2016 |
| Goodman, Shirley | Woodbury | 162284-4W | May 17, 2016 |
| Grosso, Mario Anthony | Northampton | 174213-9W | May 17, 2016 |
| Henrichs, Michael H. | Rochester | S06989-8W | May 17, 2016 |
| Herbold, Richard J. | Clifton Park | C02731-0W | May 17, 2016 |
| Hoy, Erik Alexander | Hochessin | 265536-3W | May 17, 2016 |
| Hoyt, Suzanne Marie | Manlius | C05412-4W | May 17, 2016 |
| Hulicka, Irene M. | Buffalo | S02759-9W | May 17, 2016 |
| Izquierdo, Serafin | Bronx | C01533-1W | May 17, 2016 |
| Jacoby, Mel Stewart | Boynton Beach | 104185-4B | May 17, 2016 |
| Jaffe, Robert | New York | 071294-3W | May 17, 2016 |
| Javier, Jaime K. | Edgartown | 105381-8W | May 17, 2016 |
| Karlin, David B. | New York | 077580-9W | May 17, 2016 |
| Kayden, Herbert Jay | New York | 042743-5W | May 17, 2016 |
| Klavins, Janis Viliberts | Scarsdale | 095981-7W | May 17, 2016 |
| Laine, Jean V. | Brooklyn | C11370-6W | May 17, 2016 |
| Lapin, Robert H. | Ardsley | 089353-7W | May 17, 2016 |
| Levine, Milton Leon | Elmont | 077330-9W | May 17, 2016 |
| Langen, Joseph G. | Leroy | S05045-0B | May 17, 2016 |
| Menichella, Dominic N. | Staten Island | C00243-8W | May 17, 2016 |
| Mindel Frederick | New York | C05089-0W | May 17, 2016 |
| Monajati, Ahmad | Rochester | 113632-4W | May 17, 2016 |
| Nastasi, Anthony John | Staten Island | 086673-1B | May 17, 2016 |
| Okin, Jay A. | New York | C01807-9B | May 17, 2016 |
| Pantling, Craig S. | Williamsville | C12306-9W | May 17, 2016 |
| Pichel, Richard | New York | 081535-7W | May 17, 2016 |
| Radpasand, Mohsen | Tampa | C11944-8I | May 17, 2016 |
| Reina, Charles R. | Easton | 126879-6B | May 17, 2016 |
| Romac, Michael Duane | Hoosick Falls | 189731-3B | May 17, 2016 |
| Saltsman, Dawn Marie | Hartsdale | C06021-2W | May 17, 2016 |
| Sander, Fred M. | New York | 093721-9W | May 18, 2016 |
| Scherz, Malcolm E. | Staten Island | S04520-3B | May 18, 2016 |
| Shah, Jaimin Dilipkumar | North Wales | 275150-1W | May 18, 2016 |
| Sim, Young Ja | Scotia | 123279-2W | May 18, 2016 |
| Slavin, James A. | Troy | 136743-2W | May 18, 2016 |
| Stevens, Louis Wirth | Olean | 099422-8W | May 18, 2016 |
| Suynov, Mazal Jennifer | Hempstead | C11936-4B | May 18, 2016 |
| Swire, Edward T. | Clifton Park | 094761-4W | May 18, 2016 |
| Trzcinski, Mercedes Mary | Buffalo | C02764-1B | May 18, 2016 |
| Tyler, Chad Peterson | Tonawanda | 259454-7W | May 18, 2016 |
| Vamenta, Cipriano N., 3D | Garrison | 111019-6W | May 18, 2016 |
| Winyard, Albert E., III | Astoria | 136969-3W | May 18, 2016 |
| Zapata, Vega Maria Isabel | Harker Heights | 226604-7W | May 18, 2016 |
| Zeitler, Eugene Robert | Sherman | C10277-4I | May 18, 2016 |
* 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.
Kenneth J. Munnelly
Chair