Subject Numbers Regarding Health Provider Authorizations
October 4, 2018
The following have been added to the list of providers authorized to treat injured workers and/or perform independent medical examinations within the New York State workers’ compensation system.
| NAME | SPECIALTY AREA OF PRACTICE | CITY OF PRACTICE | AUTHORIZATION NUMBER* | EFFECTIVE DATE |
|---|---|---|---|---|
| Baik, Michael Hyun | Anesthesiology | Rochester | 274479-5W | September 20, 2018 |
| Barouch, Andrea Fae | Anesthesiology | Suffern | 252566-5W | September 18, 2018 |
| Bellaousov, Katsiaryna | Anesthesiology | Rochester | 281013-3W | September 24, 2018 |
| Chiao, Franklin | Anesthesiology | Mount Kisco | 254449-2B | September 25, 2018 |
| Correll, Lynn Rudner | Anesthesiology | Rochester | 273300-4W | September 24, 2018 |
| Dave, Anjalee | Anesthesiology | New York | 234182-4W | September 18, 2018 |
| Ferreras, Krystal Marie | Anesthesiology | New Hyde Park | 291440-6W | September 12, 2018 |
| Kianpour, Daniel Nasser | Anesthesiology | Rochester | 293157-4W | September 24, 2018 |
| Kime, Courtney Kristine | Anesthesiology | Rochester | 295043-4W | September 20, 2018 |
| Kirzner, Amanda Rachel | Anesthesiology | Merrick | 287760-3W | September 25, 2018 |
| Kundu, Tripali | Anesthesiology | Melville | 290304-5W | September 24, 2018 |
| Mullally, Lena Qiaoling | Anesthesiology | Lido Beach | 294272-0W | September 19, 2018 |
| O’Neill, Daniel John | Anesthesiology | New York | 292446-2W | September 24, 2018 |
| Peacock, Jennifer Nicole | Anesthesiology | Long Island City | 277672-2W | September 12, 2018 |
| Ruby, Jordan Max | Anesthesiology | New York | 292779-6W | September 24, 2018 |
| Sverdlova, Julia | Anesthesiology | Smithtown | 282724-4W | September 24, 2018 |
| Storey, James Andrew | Cardiovascular Disease, Clinical Cardiac Electrophysiology | Elmira | 287699-6W | September 20, 2018 |
| Brandt, Kathleen Frances | Chiropractic | Liberty | C13131-0B | September 28, 2018 |
| Chouinard, Ginger L. | Chiropractic | Huntington Station | C08093-9W | September 28, 2018 |
| Christensen, Shelley Ann | Chiropractic | Manlius | C12904-1B | September 28, 2018 |
| Chzechowski, Cara Rae | Chiropractic | Holland | C13055-1B | September 28, 2018 |
| Gebraiel, Peter | Chiropractic | Staten Island | C12629-4W | September 28, 2018 |
| Gilmore, Jennifer Lynn | Chiropractic | Tonawanda | C12901-7W | September 28, 2018 |
| Lacroix, Brad | Chiropractic | Brooklyn | C12121-2W | September 28, 2018 |
| Al-Haddad, Marwan Mohammad | Dermatology | New Hartford | 295454-3B | September 28, 2018 |
| Agarwal, Sheela | Diagnostic Radiology | New York | 285504-7W | September 24, 2018 |
| Agonafer, Senayet Dereje | Diagnostic Radiology | New York | 285336-4W | September 24, 2018 |
| Baron, Keren Tuvia | Diagnostic Radiology | New York | 250467-8W | September 24, 2018 |
| Chin, Christopher Mark | Diagnostic Radiology | Brooklyn | 262081-3W | September 18, 2018 |
| Dieudonne, Gregory | Diagnostic Radiology | Rochester | 245738-0W | September 24, 2018 |
| Gong, Richard Wah | Diagnostic Radiology | Rochester | 256327-8W | September 24, 2018 |
| Joshi, Vivek | Diagnostic Radiology | Mineola | 269215-0B | September 12, 2018 |
| Kuong, Sharon Jane | Diagnostic Radiology | Brooklyn | 240815-1W | September 19, 2018 |
| Mathew, Nija Isabel | Diagnostic Radiology | Mineola | 250772-1W | September 12, 2018 |
| Oppenheimer, Daniel Corey | Diagnostic Radiology | West Henrietta | 287183-8W | September 20, 2018 |
| Safir, Julian | Diagnostic Radiology | Old Westbury | 191860-6B | September 12, 2018 |
| Cruz-Menoyo, Priscilla Marie | Emergency Medicine | Stony Brook | 292679-8W | September 24, 2018 |
| Dynof, Francis Ronald | Emergency Medicine | Yonkers | 134859-8W | September 25, 2018 |
| English, Bryan Patrick | Emergency Medicine | Stony Brook | 292896-8W | September 24, 2018 |
| Gordon, David Hirsch | Emergency Medicine | Stony Brook | 294519-4W | September 24, 2018 |
| Lohse, Matthew Robert | Emergency Medicine | Stony Brook | 293137-6W | September 24, 2018 |
| Adiletta, Christopher Michael | Family Practice | East Syracuse | 292969-3W | September 19, 2018 |
| Di Bari, Jeremy Andrew | Family Practice | Queensbury | 295127-5W | September 18, 2018 |
| Khan, Asma | Family Practice | Nyack | 261833-8I | September 28, 2018 |
| La Rosa, Francesca Vincenza | Family Practice | Levittown | 281399-6W | September 18, 2018 |
| Matalia, Neil B. | Family Practice | Nanuet | 287026-9B | September 18, 2018 |
| Nagrare, Nupur | Family Practice | Ogdensburg | 290759-0W | September 24, 2018 |
| Abraham, Ami | Internal Medicine, Pulmonary Disease, Critical Care Medicine | East Setauket | 262687-7W | September 24, 2018 |
| Adams, Hugh William | Internal Medicine, Pediatrics | Rochester | 292685-5W | September 24, 2018 |
| Ahmad, Anees | Internal Medicine | Amherst | 237483-3W | September 24, 2018 |
| Clores, Michael James | Internal Medicine | Stony Brook | 292533-7W | September 24, 2018 |
| Coch, Reilly Washington | Internal Medicine, Endocrinology, Diabetes and Metabolism | Ithaca | 245671-3W | September 20, 2018 |
| Khan, Sara Atiq | Internal Medicine | Stony Brook | 294424-7W | September 24, 2018 |
| Kim, Steven Namgi | Internal Medicine | New York | 209838-2W | September 24, 2018 |
| Koul, Suneel Mohan | Internal Medicine | Pittsford | 208275-8B | September 19, 2018 |
| Kuperberg, Stephen J. | Internal Medicine, Pulmonary Disease, Critical Care Medicine | Stony Brook | 266079-3B | September 24, 2018 |
| Patel, Ishan Jitendra | Internal Medicine | Stony Brook | 292059-3W | September 24, 2018 |
| Reyes, Raquel | Internal Medicine, Pediatrics | Geneva | 268898-4W | September 20, 2018 |
| Shah, Ronak Tushar | Internal Medicine, Pulmonary Disease | Stony Brook | 281096-8W | September 24, 2018 |
| Treidler, Simona Octaviana | Internal Medicine, Neurology | Stony Brook | 282831-7W | September 24, 2018 |
| Galgano, Michael A. | Neurological Surgery | Syracuse | 294452-8W | September 12, 2018 |
| Bezov, David | Neurology | Brooklyn | 268341-5W | September 19, 2018 |
| Blond, Benjamin Neil | Neurology | Stony Brook | 292476-9B | September 24, 2018 |
| Liebling, Courtney Naomi Brooke | Neurology | Stony Brook | 291520-5W | September 24, 2018 |
| Lipton, Ross Eliott | Neurology | Port Jefferson | 202189-7W | September 24, 2018 |
| Maindiratta, Reema | Neurology | Babylon | 203259-7B | September 19, 2018 |
| Marchidann, Adrian | Neurology | Stony Brook | 263981-3B | September 24, 2018 |
| Kutsenok, Anna Victorovna | Obstetrics/Gynecology | Stony Brook | 294451-0W | September 24, 2018 |
| Belliappa, Sonia | Ophthalmology | Pomona | 257944-9B | September 24, 2018 |
| Bouchard, Chad Phillip | Ophthalmology | Slingerlands | 293837-1W | September 19, 2018 |
| Reynolds, Andrew Lindell | Ophthalmology | Buffalo | 284890-1W | September 18, 2018 |
| Belkin, Nicole Stephanie | Orthopedic Surgery | Peekskill | 278273-8W | September 25, 2018 |
| Brown, Landon Dean | Orthopedic Surgery | Poughkeepsie | 293986-6W | September 18, 2018 |
| Cody, Elizabeth Ann | Orthopedic Surgery | New York | 271745-2W | September 28, 2018 |
| Donovan, Daniel Stephen | Orthopedic Surgery | Albany | 271418-6W | September 12, 2018 |
| Dykes, Daryll Christopher | Orthopedic Surgery | East Syracuse | 292638-4B | September 12, 2018 |
| Mahmood, Bilal | Orthopedic Surgery, Hand Surgery | Clifton Park | 271758-5W | September 20, 2018 |
| Mantica, Abigail Louise | Orthopedic Surgery | Albany | 295034-3W | September 18, 2018 |
| O’Donnell, Marc Jerome | Orthopedic Surgery, Hand Surgery | Rochester | 295438-6W | September 20, 2018 |
| Riggs, Cassandra Nicole | Orthopedic Surgery | Syracuse | 294454-4W | September 18, 2018 |
| Seigerman, Daniel Allan | Orthopedic Surgery | Tarrytown | 294516-0B | September 25, 2018 |
| Tombler, Richard Dany | Orthopedic Surgery | Canton | 271448-3W | September 28, 2018 |
| Rieth, Katherine Keiko Suzuki | Otolaryngology | Rochester | 294112-8W | September 24, 2018 |
| Sakano, Hitomi | Otolaryngology | Rochester | 293768-8W | September 20, 2018 |
| Quirolgico, Kristina Marie | Physical Medicine/Rehabilitation | New York | 293421-4W | September 12, 2018 |
| Esmond, Gerald A. | Podiatry | Port Washington | P05582-3B | September 17, 2018 |
| Lovell, Christopher Lee | Podiatry | Mount Kisco | P06790-1W | September 17, 2018 |
| Tsvaygenbaum, Raisa | Podiatry | Lake Katrine | P06874-3B | September 17, 2018 |
| Verbofsky, Evan Michael | Podiatry | Rochester | P06921-2W | September 17, 2018 |
| Vysotskyy, Taras | Podiatry | Poughkeepsie | P06852-9W | September 17, 2018 |
| Wong, David Tom | Podiatry | Bronx | P06302-5B | September 17, 2018 |
| Broughton, John M. | Psychology | New York | S05556-6W | September 27, 2018 |
| Cooper, Marty Aaron | Psychology | New York | S21944-4W | September 27, 2018 |
| Fraser, Suzanne Rowland | Psychology | Tupper Lake | S15429-4W | September 27, 2018 |
| Kalmanson, Julia | Psychology | Mount Kisco | S21142-5B | September 27, 2018 |
| Kramer, Alexis Joann | Psychology | Staten Island | S21150-8W | September 27, 2018 |
| Lozano, Christian Ivan | Psychology | Queens | S22480-8W | September 27, 2018 |
| Monge, Angela | Psychology | Bronx | S21814-9W | September 27, 2018 |
| Moss, Jennifer Ruth | Psychology | New York | S22174-7W | September 27, 2018 |
| Ostroy, Elena W. | Psychology | Elmhurst | S16854-2B | September 27, 2018 |
| Renedo, Julia Isabel | Psychology | Great Neck | S22359-4W | September 27, 2018 |
| Robinson, Elfe Kulinna | Psychology | Woodstock | S14395-8I | September 27, 2018 |
| Seskin, Lynn | Psychology | Huntington | S18387-1W | September 27, 2018 |
| Tannenbaum, Lori | Psychology | Elmhurst | S17780-8W | September 27, 2018 |
| Warner, Matthew Lloyd | Psychology | Fishkill | S10839-9W | September 27, 2018 |
| Ottavio, Peter | Pulmonary Disease, Critical Care Medicine | East Setauket | 232660-1W | September 24, 2018 |
| Ali, Sara | Radiology – Diagnostic Radiology | New York | 288112-6W | September 24, 2018 |
| Giampa, Joseph Michael | Radiology – Diagnostic Radiology | Latham | 292617-8W | September 18, 2018 |
| Gupta, Subah | Radiology – Diagnostic Radiology, Neuroradiology | Brooklyn | 287211-7W | September 19, 2018 |
| Liu, Corinne | Radiology – Diagnostic Radiology | Mineola | 254485-6W | September 12, 2018 |
| Margulis, Yevgeniy | Radiology – Diagnostic Radiology, Neuroradiology | Brooklyn | 222819-5W | September 19, 2018 |
* Providers authorized to treat and perform independent medical examinations have an authorization number ending in B. Providers authorized to only treat have an authorization number ending in W. Providers authorized to only perform independent medical examinations have an authorization number ending in I.
Any questions regarding the authorized lists should be referred to the Medical Director’s Office at 1 (800) 781-2362.
Clarissa M. Rodriguez
Chair