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Subject Number 046-1152 Voluntary Resignation of Dr. Ajay Narendra Kiri

Subject Numbers Regarding Health Provider Authorizations

Authorization No. 259884-5W

April 4, 2019

Please be advised that Dr. Ajay Narendra Kiri has resigned his authorization to treat injured workers in the New York State workersí compensation system effective April 4, 2019. Dr. Kiriís authorization was previously temporarily suspended effective March 29, 2019 by Subject Number 046-1150. Dr. Kiriís last known business addresses are:

119 West 57th Street, Suite 1101
New York, New York 10019

3505 E Tremont Avenue
Bronx, New York 10465

31-09 Newton Avenue, Suite 211
Astoria, New York 11102

59-01 94th Street, Suite E10
Elmhurst, New York 11373

3109 Newtown Avenue, Suite 211
Astoria, New York 11102

59-07 94th Street, Suite E8
Elmhurst, New York 11373

Dr. Kiri is prohibited from rendering treatment and care to injured workers and from conducting reviews of records regarding variance requests pursuant to 12 NYCRR ß 324.3(b)(2)(ii)(a). Reports submitted by Dr. Kiri for services rendered on or prior to March 28, 2019, are valid, but are invalid for any services rendered after that date. Requests to cross-examine Dr. Kiri for services rendered prior to March 29, 2019, should not be denied due to his resignation.

Any questions regarding the authorized lists should be referred to the Medical Directorís Office at 1 (800) 781-2362.

Clarissa M. Rodriguez