Subject Numbers Regarding Health Provider Authorizations
April 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 |
|---|---|---|---|
| Aguilar, David Emil | Austin | C11576-8B | February 14, 2017 |
| Ahmed, Naeem | Staten Island | 140418-5W | February 14, 2017 |
| Alba, Augusta Strongman | Massapequa | 073634-8W | February 14, 2017 |
| Baxi, Rashmikant Kantilal | Roslyn | 135851-4W | February 14, 2017 |
| Bohan, Joseph P. | Olean | 119943-9W | February 14, 2017 |
| Boxhill, Agnes M. | Lewes | 142451-4W | February 14, 2017 |
| Brigandi, Angelo Ronald | Rochester | 087040-2W | February 14, 2017 |
| Brown, Charles S. | Thompson Ridge | C00036-6B | February 14, 2017 |
| Carroll, David F. | Norwood | C10955-5I | February 15, 2017 |
| Cedarbaum, David Paul | Ithaca | C05308-4B | February 15, 2017 |
| Deangelis, Richard Anthony | Valley Stream | C06905-6B | February 15, 2017 |
| Deutsch, Frederic H. | New York | 072768-5W | February 15, 2017 |
| Dewar, Kate Marie | Elmira | 261011-1W | February 15, 2017 |
| Distenfeld, Ariel | New York | 080901-2B | February 15, 2017 |
| Dyro, Frances Mary | West Roxbury | 110985-9W | February 15, 2017 |
| Ellenbogen, David Jason | Commack | P06125-0W | February 15, 2017 |
| Eppley, Suzanne Margaret | Salem | 143465-3W | February 15, 2017 |
| Fagan, James M. | Cooperstown | 113405-5B | February 15, 2017 |
| Farman, Jack | Great Neck | 102731-7W | February 15, 2017 |
| Fast, Avital | Brooklyn | 167979-4B | February 15, 2017 |
| Fathalla, Mahmoud F. | Norwich | 200069-3B | February 16, 2017 |
| Flannigan, Thomas A. | Little Neck | C05661-6W | February 16, 2017 |
| Flores, Lamberto V. | Staten Island | 126185-8W | February 16, 2017 |
| Greenberg, Henry Morton | New York | 101067-7W | February 16, 2017 |
| Hlaing, Thinn | Great Neck | 253420-4B | February 16, 2017 |
| Jagoda, Joshua Barry | White Plains | C11956-2B | February 16, 2017 |
| Jayagopal, Sharada | E Williston | 151424-9W | February 16, 2017 |
| Kam, Joseph J. | Buffalo | C00845-0W | February 16, 2017 |
| Kazdin, Hal J. | Brooklyn | 145170-7W | February 16, 2017 |
| Klebanov, Roman | Brooklyn | 151364-7W | February 16, 2017 |
| Koppel, Neil J. | Naples | C08178-8B | February 16, 2017 |
| Lucia-Russell, Robin | Mount Vernon | C04166-7W | February 16, 2017 |
| Mahdavian, Jalal | Kingston | 097334-7W | February 16, 2017 |
| Mantena, Raju Madhav Murali | Roslyn Heights | 227337-3W | February 16, 2017 |
| Marvel, Matthew Edgar | Syracuse | 173411-0W | February 17, 2017 |
| Mazza, Michael Angelo | Spencerport | 082768-3W | February 17, 2017 |
| Mehrotra, Vishnu G. | Troy | 129891-8W | February 17, 2017 |
| Mustapha, Rahma Marikar | Valatie | 123180-2B | February 17, 2017 |
| Nassoiy, Elisa Lynn | Grand Island | C11954-7W | February 17, 2017 |
| Nguyen, Binh Nhu | Bayside | C10471-3B | February 17, 2017 |
| Occhino, Frederick Michael | Estero | 108941-6B | February 17, 2017 |
| Panner, Bernard J. | Rochester | 084849-9W | February 17, 2017 |
| Patil, Kashinath B. | Pittsford | 107458-2W | February 17, 2017 |
| Peck, Rochelle L. | New York | 153620-0W | February 21, 2017 |
| Perumal, Subramanian | Bronx | 119300-2W | February 21, 2017 |
| Pincus, Martin Mark | New York | 127900-9B | February 21, 2017 |
| Prior, Mark Christopher | Depew | C10264-2B | February 21, 2017 |
| Ramos, Raul Alejandro | Rock Hill | 221370-0W | February 21, 2017 |
| Resurreccion, Ernesto C. | Belle Harbor | 111541-9W | February 21, 2017 |
| Riaz, Aasma | Middletown | 270211-6W | February 22, 2017 |
| Rissacher, Tred John | Stuart | C05519-6B | February 22, 2017 |
| Rovelli, Paul Mario | Deer Park | S13722-4B | February 22, 2017 |
| Sarakhun, Chalermpong | New York | 118443-1B | February 22, 2017 |
| Schively, Dora Hammar | Salisbury | 104268-8W | February 22, 2017 |
| Selina-Segal, Natalya | Horseheads | 236822-3W | February 22, 2017 |
| Serpe, Salvatore John | Amityville | 080529-1B | February 22, 2017 |
| Shah, Kokila B. | Jericho | 153741-4W | February 22, 2017 |
| Shalit, Shimon | Harrison | 095582-3W | February 22, 2017 |
| Valente, Domenico | Plainview | 121883-3W | February 22, 2017 |
| Sifontes, Lionel Anthony | Buffalo | 103484-2W | February 22, 2017 |
| Sunwoo, Moon | Hartsdale | 107723-9W | February 22, 2017 |
| Troncoso, Raudo Antonio | Mount Kisco | 105023-6W | February 22, 2017 |
| Ungar, Heidi Elizabeth | New York | 272864-0W | February 22, 2017 |
| Van Dine, Kenneth G. | Wellsville | 100546-1W | February 23, 2017 |
| Vivera, Arsenio B. | New York | 097625-8W | February 23, 2017 |
| Whelen, Barbara E. | Patchogue | C06680-5B | February 23, 2017 |
| Yiannou, James | Yonkers | 087350-5W | February 23, 2017 |
| Zalmanov, Mikhail I. | Rego Park | 158429-1W | February 23, 2017 |
| Zimberg, Sheldon | New York | 087798-5W | February 23, 2017 |
* 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