Subject Numbers Regarding Health Provider Authorizations
May 13, 2021
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 |
|---|---|---|---|
| Ardila Gatas, Jessica Alexandra | Stony Brook | 296725-5W | March 10, 2021 |
| Barrow, Daniel Webster | Dobbs Ferry | PT042655-1W | March 10, 2021 |
| Bennett, Christopher Joseph | Waukesha | 263602-5W | March 10, 2021 |
| Berdufi, Klejdja | Lyndhurst | PT042672-6W | March 10, 2021 |
| Bernstein, William Harvey | New City | 091619-7W | March 10, 2021 |
| Bertrand, Bruce Kenneth | Sterling | 199697-4W | March 10, 2021 |
| Bien, Alexander Gregory | Albany | 278738-0W | March 10, 2021 |
| Blumenthal, Jesse Arthur | New York | 087016-2W | March 10, 2021 |
| Boddhula, Sowmya | Cooperstown | 288270-2W | March 10, 2021 |
| Brasch, Robert Charles | Latham | 207050-6W | March 10, 2021 |
| Brustein, Jerome Marc | Vero Beach | 177218-5W | March 10, 2021 |
| Casimir, Stephen A. | Endicott | 087816-5W | March 10, 2021 |
| Chastanet, David Adrien | White Plains | 101275-6W | March 10, 2021 |
| Darer, Jacobo | White Plains | 137078-2W | March 10, 2021 |
| De Sousa, Jerslin | Rockaway Beach | C12739-1I | March 10, 2021 |
| Dean, Shannon Lee | Rochester | 289101-8W | March 10, 2021 |
| Defrank Castro, Joseph Miguel | Johnson City | 262824-6W | March 10, 2021 |
| Delacruz-Gomez, Rafael Antonio | Queens Village | 185160-9W | March 10, 2021 |
| Diaz, Fredie Colon | Albuquerque | 199224-7W | March 10, 2021 |
| Diokno, Raul D. | Loudonville | 128527-9W | March 10, 2021 |
| Fallis, Karen | Roslyn | 131055-6W | March 6, 2021 |
| Frater, Robert William Mayo | Bronxville | 094718-4W | March 10, 2021 |
| Goldstein, Marshall F. | Pittsfield | 124596-8W | March 10, 2021 |
| Hamdi, Mark Elwood | Glens Falls | S12146-7W | March 10, 2021 |
| Degonzague, Kirsten Hamilton | Albany | C09755-2W | March 10, 2021 |
| Hershkowitz, David W. | Bronx | C11234-4W | March 10, 2021 |
| Hertz, Ronny | West Nyack | 139417-0W | March 10, 2021 |
| Iglesias, Richard Henry | Bronx | C04822-5W | March 10, 2021 |
| Kandalaft, Souheil I. | Hartsdale | 103071-7W | March 10, 2021 |
| Kaur, Gurvinder | Highland | 289953-2W | March 10, 2021 |
| Kay, Chester Jay | Boca Raton | 087163-2W | March 10, 2021 |
| Khan, Walayat | Dansville | 115189-3W | March 10, 2021 |
| Kheti, Yatin | Cortland | 279715-7W | March 10, 2021 |
| Klapholz, Mark Bernard | Great Neck | 143452-1W | March 10, 2021 |
| Klein, Ronald Steven | Hannacroix | 166846-6W | March 10, 2021 |
| Kommu, Swati Ramchandra | Jersey City | PT042386-3W | March 10, 2021 |
| Kressner, Michael Stewart | Cortland | 135411-7W | March 10, 2021 |
| Lagasse, Robert Scott | Stamford | 176911-6W | March 10, 2021 |
| Lebowitz, Mark Allan | Brooklyn | 156441-8W | March 10, 2021 |
| Lerner, Jean M. | Brooklyn | C03750-9W | March 10, 2021 |
| Lim, Suzanne Lee | New York | 149372-5W | March 10, 2021 |
| Modonia, Vincent Victor | Garden City | 071433-7W | March 10, 2021 |
| Mallon, William Kinney, Jr. | Stony Brook | 282233-6W | March 10, 2021 |
| Mendizabal, Edgar | Plainview | 111434-7W | March 10, 2021 |
| Messing, Samuel Louis | Boca Raton | 080971-5W | March 10, 2021 |
| Meyappan, Thiagarajan | Tarrytown | 163096-1W | March 10, 2021 |
| Mierlak, Julian A. | Brooklyn | 138709-1W | March 10, 2021 |
| Montellese, Christopher George | Monterey | C11176-7W | March 10, 2021 |
| Nayak, Ramesh B. | New York | 123187-7W | March 10, 2021 |
| Nori, Venkatesh | Lynbrook | 200931-4W | March 10, 2021 |
| O'Neill, Karen Ann | Northport | C05982-6W | March 10, 2021 |
| Pagnozzi, Paul Joseph | Hurley | 175032-2W | March 10, 2021 |
| Perri, Daniel | Middletown | 200502-3B | March 10, 2021 |
| Perry, Russell Joseph | Bronx | 198433-5W | March 10, 2021 |
| Porter, Taylor Main | Wolcott | PT042469-7W | March 10, 2021 |
| Resnik, Jack | Cayuga | 099098-6W | March 10, 2021 |
| Rosenblum, Seth | Tucson | C01949-9B | March 10, 2021 |
| Rostami, Parifar | Syracuse | 296682-8W | March 10, 2021 |
| Salky, Barry A. | Snowmass Village | 114785-9W | March 10, 2021 |
| Savarino, Daniel Stephen | Freehold | 243935-4W | March 10, 2021 |
| Shah, Syed Jibran | Mississauga | 289028-3W | March 10, 2021 |
| Shareef, Shakeel Rahman | Cleveland | 194774-6W | March 10, 2021 |
| Shiekh, Habib Ullah | Attica | 130339-5W | March 10, 2021 |
| Silverberg, Arnold I. | Brooklyn | 089730-6W | March 10, 2021 |
| Sonpal, Girishkumar M. | Bayside | 122605-9W | March 10, 2021 |
| Tabo, Libertine Magallon | Staten Island | PT042510-8 | March 10, 2021 |
| Tamar, Kyron C. | Lowville | 132492-0W | March 10, 2021 |
| Thornburg, Robert Patrick | Rochester | 227256-5W | March 10, 2021 |
| Tirrell, Paul Charles | Cooperstown | 176553-6W | March 10, 2021 |
| Vizner, Tatjana | Brooklyn | 141831-8W | March 10, 2021 |
| Weinberg, Zwi | Scarsdale | 140292-4W | March 10, 2021 |
| Weinstock, Jed | Coopertown | 270823-8W | March 10, 2021 |
| Weintraub, Steven Jeffrey | Melville | 161909-7W | March 10, 2021 |
| Wolin, David A. | Piermont | 121284-4W | March 10, 2021 |
| Xu, Annie H. | Albany | OT019971-1W | March 10, 2021 |
*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.
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.
Clarissa M. Rodriguez
Chair