Subject Numbers Regarding Health Provider Authorizations

Authorization No. 104165-6B

July 24, 2013

Please be advised that Dr. Sara Sirkin has resigned her authorizations to treat injured workers and to perform independent medical examinations in the New York State workers' compensation system effective June 27, 2013. Dr. Sirkin's last known practice address is 2441 Sheridan Drive, Tonawanda, New York 14150.

Dr. Sirkin is prohibited from rendering treatment and care to injured workers and from performing independent medical examinations. Reports submitted by Dr. Sirkin for services rendered prior to June 27, 2013, are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Sirkin for services rendered prior to June 27, 2013, should not be denied due to the resignation of her authorizations.

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