Subject Numbers Regarding Health Provider Authorizations

Authorization No. 208260-0W

January 18, 2022

Please be advised that Dr. Luis M. Fandos has resigned his authorization to treat injured workers in the New York State workers' compensation system effective January 12, 2022. Dr. Fandos' last known practice addresses are:

8 Saxon Avenue, Suite E
Bay Shore, New York 11706

500 W Main Street, Suite 116
Babylon, New York 11702

and

100 W Main Street, Suite C
Babylon Village, New York 11702

Dr. Fandos is prohibited from rendering treatment and care to injured workers, and from conducting reviews of records regarding variance requests pursuant to 12 NYCRR § 324.3(b)(2)(ii)(a).

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