Subject Numbers Regarding Health Provider Authorizations
December 21, 2022
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 |
|---|---|---|---|
| Mustafa Abdulrahman | Farmingville | 305591-0W | October 28, 2022 |
| Molave A. Adaniel | Dix Hills | 111104-6W | October 28, 2022 |
| Vincent Yao Adofoli | New York | C12870-2B | October 28, 2022 |
| Gregory J. Adornetto | Fort Lauderdale | P02891-0W | October 28, 2022 |
| Keriosv Ammonius | Bayside | PT037321-7W | October 28, 2022 |
| Srilakshmi Atluri | New York | 276735-8W | October 28, 2022 |
| Dustin Baldwin | Astoria | PT044396-0W | October 28, 2022 |
| Eduardo D. Bernales | Staten Island | 124984-6W | October 28, 2022 |
| Paul J. Betschart | Danbury | P05002-2W | October 28, 2022 |
| Shabir Bhayani | Olean | 172880-7W | October 28, 2022 |
| Paul Abraham Bienstock | New York | 092543-8W | October 28, 2022 |
| Matthew J. Boheen | Webster | C11932-1B | October 28, 2022 |
| Philip A. Bonanno | Glen Cove | 124617-2B | October 28, 2022 |
| Michael F. Boyle | Leesburg | 252288-6W | October 28, 2022 |
| John R. Brereton | Newport | 131008-5W | October 28, 2022 |
| Richard F. Brodman | Mount Desert | 124991-1W | October 28, 2022 |
| Samuel Alan Brody | Wilmington | 153180-5W | October 28, 2022 |
| Abby Ilene Budnick | East Meadow | C05679-6W | October 28, 2022 |
| Richard Michael Burg | White Plains | 111819-9W | October 28, 2022 |
| Valentine Jewell Burroughs | Nyack | 135716-9W | October 28, 2022 |
| William A. Busino, Jr. | Schenectady | 127275-6W | October 28, 2022 |
| Jose Antonio Noriega | Houston | 275168-3W | October 28, 2022 |
| Robert Lord Caldwell | Scottsville | 089585-4W | October 28, 2022 |
| Paul James Capobianco | Pembroke Pines | 199975-4W | October 28, 2022 |
| Norbert,Joe Cardoso | East Amherst | 251785-2W | October 28, 2022 |
| Manasi Dhiren Chalishazar | Englewood | PT041242-9W | October 28, 2022 |
| Joseph Leonce Charlot, Jr. | Charlotte | 272543-0W | October 28, 2022 |
| Norman E. Chase | New York | 078800-0W | October 28, 2022 |
| Yuliya Chernyak | Staten Island | AC003795-2W | October 28, 2022 |
| Cheryl Lynn Clark | New York | 211867-7W | October 28, 2022 |
| Gerald L. Corva | Garden City | C03399-3B | October 28, 2022 |
| Dzmitry Dadonau | Brooklyn | AC006542-5W | October 28, 2022 |
| David Paul Dever | Las Cruces | 146560-8B | October 28, 2022 |
| Dominic Peter Di Vincenzo | Spencerport | 086467-8W | October 28, 2022 |
| John S. Dierna | Webster | C06260-4W | October 28, 2022 |
| Guy A. Ditommaso | Cape Coral | C02498-4W | October 28, 2022 |
| Richard B. Dixon | East Syracuse | C03332-4W | October 28, 2022 |
| Robert Michael Domke | Carmel | 190452-3W | October 28, 2022 |
| John Rudolph Drudy | Hampton Bays | C05327-4W | October 28, 2022 |
| Nathaniel Todd Fiedler | Troy | PT037358-9W | October 28, 2022 |
| Daniel Joseph Finn | Albany | 165751-9W | October 28, 2022 |
| Ofelia R. Flores | Hartsdale | 107550-6W | June 11, 2020 |
| Oleg Rafaelovich Fuzaylov | Kew Gardens | 220254-7B | October 28, 2022 |
| Mildred Garcia | Port Jefferson | 220400-6W | October 28, 2022 |
| Shawn Michael Gaston | Livingston | PT036459-6W | October 28, 2022 |
| Riva Goldenberg | Brooklyn | 258052-0B | October 28, 2022 |
| Raja S. Gopalan | Fredonia | 113439-4W | October 28, 2022 |
| Michael H. Gordon | New York | 120344-7I | October 28, 2022 |
| Ronald H. Gottlieb | Sarasota | 149074-7W | October 28, 2022 |
| Mary Grace Guenther | Pine City | AC006559-9W | October 28, 2022 |
| Ashutosh Gupta | West Sayville | 213960-8W | October 28, 2022 |
| Arnold Marc Hertz | Cedarhurst | P02948-8W | October 28, 2022 |
| Kristen Dainton Hilliard | Panama City | C10454-7W | October 28, 2022 |
| Debra Hoolahan | Sayville | C07215-7B | October 28, 2022 |
| Harold L. Husovsky | Syracuse | 184017-2W | October 28, 2022 |
| Sonia W. Hyman | New York | 092646-9W | October 28, 2022 |
| Joseph Cody Ibarra | West Hartford | PT044432-3W | October 28, 2022 |
| Michael Alando Johnson | Alleghany | 192833-2W | October 28, 2022 |
| Lee Andrews Jones | Fayetteville | 172379-0W | October 28, 2022 |
| Roger E. Kaiser, Jr. | Chattanooga | 142526-3W | October 28, 2022 |
| Ciara Anne Kazakis | Syracuse | 299288-1W | October 28, 2022 |
| Michael Francis Keane | Palenville | PT015479-9W | October 28, 2022 |
| Jessica Sheri King | Champlain | 279899-9W | October 28, 2022 |
| Robert A. Klein | Jackson Heights | P03574-1W | October 28, 2022 |
| Joseph J. Kuchinski, Jr. | Las Vegas | 181586-9B | October 28, 2022 |
| Jeon Hoo Lee | Cliffside Park | 144341-5W | October 28, 2022 |
| Louis Young Lee | Tenafly | 258545-3W | October 28, 2022 |
| Cameron Patrick Lewis | Yorktown Heights | 279427-9W | October 28, 2022 |
| Jungjae Lim | Syracuse | 306010-0W | October 28, 2022 |
| Jennifer Pauline Logan | Buena Vista | 198357-6W | October 28, 2022 |
| David M. Lowell | West Barnstable | 148838-6W | October 28, 2022 |
| Akram Hassan Mahmoud | Newton | 305839-3W | October 28, 2022 |
| James V. Manzione | Portland | 154353-7W | October 28, 2022 |
| Jonathan Howard Margolin | Teaneck | P05602-8W | October 28, 2022 |
| Rogelio Avila Martinez | San Antonio | 251377-8W | October 28, 2022 |
| Virginia E. Maurer | Mineola | 145108-7W | October 28, 2022 |
| Terence M. McGarry | Pelham | 135070-1W | October 28, 2022 |
| Aleksandra Zofia Michalik | Massapequa | 268928-9W | October 28, 2022 |
| Jeffrey S. Moretti | Staten Island | C05849-5W | October 28, 2022 |
| Richard T. Moxley, III | Cockeysville | 120854-5W | October 28, 2022 |
| Mark Roy Novick | New York | 086231-8W | October 28, 2022 |
| Anis Ibrahim Obeid | Syracuse | 100016-5B | October 28, 2022 |
| Nicole Marie Obenrader | New York | PT040717-1W | October 28, 2022 |
| Herman Oliver | Great Neck | 083821-9W | October 28, 2022 |
| Ramkumar Panhani | Queens Village | 199398-9W | October 28, 2022 |
| Thomas Arthur Pearson | Gainesville | 175541-2W | October 28, 2022 |
| Robert C. Philips | Binghamton | P02968-6B | October 28, 2022 |
| Sudhir Choudary Potluri | Clinton | 185337-3W | October 28, 2022 |
| Saul Lloyd Presberg | Rochester | 090588-5W | October 28, 2022 |
| J. Gerald Quirk, Jr. | Little Rock | 124654-5B | October 28, 2022 |
| Muhammad Raqib Raja | Naples | 107595-1W | October 28, 2022 |
| Sanford Abraham Ratzan | New York | 096801-6B | October 28, 2022 |
| Leonard Reiffe | New York | 153515-2W | October 28, 2022 |
| Ahmed Mohamed Rezk | New Hyde Park | 278589-6W | October 28, 2022 |
| Fleurgin Rochelin | Miami | 259771-4W | October 28, 2022 |
| Constance Anne Romano | Brooklyn | P04427-1W | October 28, 2022 |
| Ruth Rosenblatt | New York | 095311-7W | October 28, 2022 |
| John K. Rugge, Jr. | Chestertown | 120486-6W | October 28, 2022 |
| Marcus Richard Rusek | Forest Hills | C04547-6B | October 28, 2022 |
| Roger Errol Salisbury | Scottsdale | 147254-7W | October 28, 2022 |
| Huda Sal | Stony Brook | 280386-4B | October 28, 2022 |
| Adam Zion Schayek | New Rochelle | PT044576-7W | October 28, 2022 |
| Melissa Catherine Schroers | Roanoke | S17369-0W | October 28, 2022 |
| Steven Jeremy Schwartz | Hewlette | 097721-5B | October 28, 2022 |
| Nelson Seidman | Gainesville | C00993-6B | October 28, 2022 |
| William John Senisi | Poughkeepsie | 148468-2W | October 28, 2022 |
| Edith Senyumba | Hightstown | 261485-7W | October 28, 2022 |
| Dushyantkumar Kantilal Shah | North Reddington Beach | 147371-9W | October 28, 2022 |
| Catherine Malone Smitas | Schenectady | 243987-5W | October 28, 2022 |
| Glennell Renford Smith | Buffalo | 198956-5W | October 28, 2022 |
| Richard L. Stapen | Woodbury | 131211-5B | October 28, 2022 |
| Irving Sterman | Willow Street | 094575-8I | October 28, 2022 |
| Gregory Paul Stoltzfus | Buffalo | 298736-0W | October 28, 2022 |
| Walter H. Sturm | Lake Worth | 144461-1W | October 28, 2022 |
| Gonzalo Fernandez Urbano | Brooklyn | 180174-5W | October 28, 2022 |
| Sidney O. Veitch | New York | 128797-8W | October 28, 2022 |
| Maureen Meghan Velasco | Buffalo | PT037101-3W | October 28, 2022 |
| Brandon Nicholas Vernon | Cortland | C13259-7B | October 28, 2022 |
| Dana James Vick | Englewood | 228315-8W | October 28, 2022 |
| Kathryn Teresa Vullo | North Chili | S15139-9B | October 28, 2022 |
| Daniel Andrew Weber | Elizabethtown | PT024435-0W | October 28, 2022 |
| Lorne Everd Weeks, III | Oneonta | 238707-4W | October 28, 2022 |
| Andrew Jay Weiland | New York | 181147-0W | October 28, 2022 |
| Judith Weingram | New York | 092885-3W | October 28, 2022 |
| Richard Alan Weiss | Saint James | 180728-8B | October 28, 2022 |
| Akriti Yadav | New Hyde Park | PT040706-4W | October 28, 2022 |
| Christie Hyunsu Yi | Tenafly | 213161-3W | October 28, 2022 |
*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