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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. 046-866

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

Date: 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