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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. 046-907

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

Date: December 16, 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
Agban, Galaa Magdi Fairport 099882-3B October 26, 2016
Anderson, Gordon Brian Brooklyn 233218-7B October 26, 2016
Barker, Daniel Allen New York 275589-0W October 26, 2016
Beresford, H. Richard Ithaca 093003-2W October 26, 2016
Bernhang, Arthur M. Huntington 084142-9B October 26, 2016
Bhagavatula, Kumar Padma Temple 213851-9B October 26, 2016
Breitenstein, Bryce Dixon, Jr. Indian Wells 177836-4I October 26, 2016
Campione, Peter A. Naples 136093-2B October 26, 2016
Chamarthy, Srinivasu Dayton 268777-0W October 27, 2016
Chang, June I. Holland 162345-3W October 27, 2016
Chaput, Andre Watertown 185348-0W October 27, 2016
Charchaflieh, Jean Brooklyn 186992-4W October 27, 2016
Charles, Yardley B. Bronx 155398-1W October 27, 2016
Conley, Thomas M. Liverpool C10202-0B October 27, 2016
Cooley, Glen R. Schenectady 125746-8B October 27, 2016
Corbett, Dennis Francis Schenectady 099597-7W October 27, 2016
Derosa, Daniela A. Rochester 261574-8W October 27, 2016
Dinapoli, Robert Yulan 151098-1W October 27, 2016
Econopouly, Demetrios Sotirios Jackson Heights P04718-3B October 27, 2016
Epstein, Heywood Young Garden City 087081-6W October 27, 2016
Fazzone, Hilary Elizabeth New Haven 215120-7I October 27, 2016
Flanagan, Thomas M. Norwich 047306-6W October 27, 2016
Geiger, Arthur J. Brooklyn P01926-5W October 27, 2016
Golimbu, Cornelia Bronxville 114202-5B October 27, 2016
Guidarelli, Anthony Fred Schenectady 105592-0B October 27, 2016
Gunderia, Mita Dhruvkumar Williamsville 146828-9W October 27, 2016
Gupta, Manish Syracuse 275897-7W October 27, 2016
Gventer, Mark Brooklyn P02605-4W October 27, 2016
Hanovice, Ronald B. Kingston 149077-0W October 27, 2016
Hassenfratz, Thomas A. Buffalo P02071-9B October 27, 2016
Hausle, John C. Hilton 128290-4W October 27, 2016
Hayt, David B. New York 080080-5W October 27, 2016
Hustad, Kent Owen Syracuse 152980-9W October 27, 2016
Ignacio, Adelfino S. Staten Island 159264-1W October 27, 2016
Jolly, George A. Middle Grove 127194-9W October 27, 2016
Kajubi, Samuel Kulumbavo New Rochelle 166884-7B October 27, 2016
Kaloyanides, George J. Stony Brook 090736-0W October 27, 2016
Kalt, Wallace Bill New York 077178-2W October 27, 2016
Katari, Venkata Subrahmanyeswara South Salem 146807-3W October 27, 2016
Kearns, Kenneth Aaron Merrick 266349-0W October 27, 2016
Keirns, Carla Christine Stony Brook 253334-7B October 27, 2016
Kirshenbaum, Richard I. Brooklyn 083196-6W October 27,2016
Klein, Robert E. Brossard C01921-6B October 27, 2016
Kramer, Albert Seymour Lloyd Harbor 071380-0W October 27, 2016
Kramer, Paul Bellmore 096896-6W October 27, 2016
LaFountain, Richard B. Williamsville 138706-7W October 27, 2016
Laieta, Daniel A. Holbrook P02401-8B October 27, 2016
Lau, Anthony Ching Kwok Monroe 114627-3W October 27, 2016
Lee, Soo Duk Goshen 126793-9W October 27, 2016
Lerner, Barry Middletown P03054-4B October 27, 2016
Lowe, Phillip Alan Auburn 165303-9W October 27, 2016
Lowenstein, Robert Ernest Deansboro 138551-7W October 31, 2016
Mahoney, Paul D. Johns Island 099792-4I October 27, 2016
Mainolfi, Maria Bernadette Horseheads 266134-6W October 27, 2016
Marzziotti, Robert John Eastchester 086658-2W October 27, 2016
Masrani, Deepa Jamesville L03325-8W October 27, 2016
Mellon, Matthew Birk Massapequa 261768-6W October 27, 2016
Mescon, Marilee D. New York 132351-8B October 27, 2016
Milder, Emanuel Brooklyn 078179-9W October 27, 2016
Miraglia, Alexander J. Brooklyn P02216-0W October 27, 2016
Molomot, Leslie J. Fishkill C00909-2W October 27, 2016
Muchnick, Richard Stuart New York 101375-4B October 27, 2016
Nelligar, Steven V. New York C06875-9B October 27, 2016
Nichols, John Edwin Canandaigua 184779-7W October 27, 2016
Nogrady, Judd Montgomery C08124-0B October 27, 2016
Ortiguera, Jose M. Westbury 111478-4W October 27, 2016
Pechenik, Boris Buffalo 206701-5W October 27, 2016
Reichbach, Steven Melville 195068-2W October 27, 2016
Reilly, Kevin B. Mt. Kisco 109025-7W October 27, 2016
Replogle, Robert Edward Rochester 259529-6W October 27, 2016
Siegler, David Hastings on the Hudson 148740-4W October 27, 2016
Sollazzo, Richard Nissequoque C02456-2I October 27, 2016
Spenser, Ciprian Raoul Chino 242705-2W October 27, 2016
Surya, Gerald New Hyde Park 204213-3W October 27, 2016
Szeremeta, Wasyl Plainview 258074-4W October 27, 2016
Trinidad, John R. East Northport P02883-7W October 27, 2016
Wallis, Lila Amdurska Rhinebeck 073742-9W October 27, 2016
Walsh, George Francis, Jr. Pittsford 097410-5W October 27, 2016
Yudell, Gerald Irving Mt. Vernon 084508-1W October 27, 2016
Yurt, Roger W. New York 130553-1W October 27, 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