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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. 046-916

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

Date: January 19, 2017

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
Abaza, Ashraf Hussein Kings Park 194744-9W November 14, 2016
Agus, Bertrand New York 097341-2W November 14, 2016
Aiello, Maria Therese Brooklyn 122999-6W November 14, 2016
Albrecht, Charles H. Clifton Springs 150218-6W November 14, 2016
Augustyniak, Bozena Bronx 212666-2W November 14, 2016
Bancroft, George H. Rancho Mirage 150369-7W November 14, 2016
Becker, Jack S. Hewlett P02591-7B November 14, 2016
Bergenstock, Ray W. Buffalo 140927-5W November 14, 2016
Bishop, Ralph M. Huntersville 103180-6W November 14, 2016
Bishop, William Clark Elmira 145621-9W November 14, 2016
Bollet, Alfred J. Sand Point 049437-7W November 14, 2016
Bonner, Anthony Joseph Youngstown 104128-4W November 15, 2016
Bottger, Bradford Alan Redding 180790-8W November 15, 2016
Bryk, David Cedarhurst 075422-6W November 15, 2016
Canter, Joel Standfordville 106093-8W November 15, 2016
Chabra, Dave Cedarhurst P03398-6W November 15, 2016
Chiarieri, Dominick R. Mt. Kisco 124033-2W November 15, 2016
Cole, Frank Clyde, III Norwich 183739-2W November 15, 2016
Contini, William Vestal 097965-8W November 15, 2016
Dabbagh, Raghda Smithtown 187959-2W November 15, 2016
Del Monico, Michael Louis Rhinebeck 080291-8W November 15, 2016
Doft, Martin D. New York 098870-9B November 15, 2016
Dossett, James Robert Orchard Park C11978-6W November 15, 2016
Ewing, Kenneth Anthony Port Washington 109869-8W November 15, 2016
Fastook, Jeanne Marie New York 106692-7W November 15, 2016
Fasuli, Stavrula G. East Elmhurst 138225-8W November 15, 2016
Fedson-Hack, Anjali Karen New York 235418-1B November 15, 2016
Frank, Robert Jay Forest Hills 127865-4W November 15, 2016
Fried, Robert Carmel S10326-7W November 15, 2016
Friedman, David Richard Cooperstown 170707-4W November 15, 2016
Gayam, Sirisha Johnson City 276168-2W November 15, 2016
Goebel, David Forest Hills 074129-8W November 15, 2016
Goldfarb, Steven Richard Rochester 166568-6W November 16, 2016
Goodman, Alvin I. New York 079171-5W November 16, 2016
Guthinger, William P. Batavia 123840-1W November 16, 2016
Johnson, Lance Arlington New City C06826-4B November 16, 2016
Kasireddy, Krishna Kishor Johnson City 276270-6W November 16, 2016
Kelly, John Edward, Jr. Bradenton 082964-8B November 16, 2016
Khorasani, Mohammad Reza Roseville 267176-6I November 16, 2016
Lempert, Philip Ithaca 090378-1W November 16, 2016
Logue, Gerald Lee Buffalo 149284-2W November 16, 2016
Manderson, Lawton Vincent Bellmore 076842-4W November 8, 2016
Marshall, James H. Alpine 086875-2B November 16, 2016
Mazur, John Plattsburgh 108617-2W November 16, 2016
McBiles, Mike Greenfield Center 237563-2B November 16, 2016
McCormick, Ellen Carroll Islip 150333-3W November 16, 2016
Meder, Tommy John Syracuse 199608-1W November 16, 2016
Meyerson, Arthur T. New York 088082-3W November 16, 2016
Millar, William Sloane Englewood 199311-2W November 16, 2016
Mower, Patricia Manion Cooperstown 154937-7W November 16, 2016
Palumbo, Anthony J. New Hartford 128709-3W November 16, 2016
Panissidi, Nino V. Williston Park 039460-1W November 16, 2016
Patel, Mahendra M. Vienna 137727-4B November 16, 2016
Plank, Benjamin Girton Billings 261674-6B November 16, 2016
Potter, Douglas H. Rochester 157896-2W November 16, 2016
Raudenbush, Elenee Margarite Rochester 276118-7W November 16, 2016
Reich, David Robert Auburn 155964-0W November 16, 2016
Reidy, James Joseph Buffalo 177988-3W November 16, 2016
Rominger, John M. Horseheads 132975-4W November 16, 2016
Rosenberg, Herman Kew Gardens P02084-3W November 16, 2016
Schley, William Shain Columbus 106153-0W November 16, 2016
Schneebaum, Carol Rosenfield Dobbs Ferry 090605-7W November 16, 2016
Schulman, Norman Harmon New York 097296-8B November 16, 2016
Schwartz, Sheldon Queens Village 042692-4B November 16, 2016
Scuderi, Richard Alfred Forest Hills 092598-2W November 16, 2016
Singh, Virendra Fremont 146886-7W November 16, 2016
Spitzer, Kenneth H. Fayetteville 093853-0B November 16, 2016
Stein, Alvin Brentwood 087850-4W November 16, 2016
Templer, Wayne C. Corning 048821-3W November 17, 2016
Tilala, Niral H. Rochester 048821-3W November 17, 2016
Visco, Alexander Joseph New York 231025-8W November 17, 2016
Watkins, Kevin Thomas Stony Brook 234159-2W November 17, 2016
Weinstock, Daniel M. Geneva 124894-7B November 17, 2016
Weiss, Oscar R. Poughkeepsie 106185-2W November 17, 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