Subject Numbers Regarding Health Provider Authorizations
December 16, 2016
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 |
|---|---|---|---|
| Agban, Galaa Magdi | Fairport | 099882-3B | October 26, 2016 |
| Anderson, Gordon Brian | Brooklyn | 233218-7B | October 26, 2016 |
| Barker, Daniel Allen | New York | 275589-0W | October 26, 2016 |
| Beresford, H. Richard | Ithaca | 093003-2W | October 26, 2016 |
| Bernhang, Arthur M. | Huntington | 084142-9B | October 26, 2016 |
| Bhagavatula, Kumar Padma | Temple | 213851-9B | October 26, 2016 |
| Breitenstein, Bryce Dixon, Jr. | Indian Wells | 177836-4I | October 26, 2016 |
| Campione, Peter A. | Naples | 136093-2B | October 26, 2016 |
| Chamarthy, Srinivasu | Dayton | 268777-0W | October 27, 2016 |
| Chang, June I. | Holland | 162345-3W | October 27, 2016 |
| Chaput, Andre | Watertown | 185348-0W | October 27, 2016 |
| Charchaflieh, Jean | Brooklyn | 186992-4W | October 27, 2016 |
| Charles, Yardley B. | Bronx | 155398-1W | October 27, 2016 |
| Conley, Thomas M. | Liverpool | C10202-0B | October 27, 2016 |
| Cooley, Glen R. | Schenectady | 125746-8B | October 27, 2016 |
| Corbett, Dennis Francis | Schenectady | 099597-7W | October 27, 2016 |
| Derosa, Daniela A. | Rochester | 261574-8W | October 27, 2016 |
| Dinapoli, Robert | Yulan | 151098-1W | October 27, 2016 |
| Econopouly, Demetrios Sotirios | Jackson Heights | P04718-3B | October 27, 2016 |
| Epstein, Heywood Young | Garden City | 087081-6W | October 27, 2016 |
| Fazzone, Hilary Elizabeth | New Haven | 215120-7I | October 27, 2016 |
| Flanagan, Thomas M. | Norwich | 047306-6W | October 27, 2016 |
| Geiger, Arthur J. | Brooklyn | P01926-5W | October 27, 2016 |
| Golimbu, Cornelia | Bronxville | 114202-5B | October 27, 2016 |
| Guidarelli, Anthony Fred | Schenectady | 105592-0B | October 27, 2016 |
| Gunderia, Mita Dhruvkumar | Williamsville | 146828-9W | October 27, 2016 |
| Gupta, Manish | Syracuse | 275897-7W | October 27, 2016 |
| Gventer, Mark | Brooklyn | P02605-4W | October 27, 2016 |
| Hanovice, Ronald B. | Kingston | 149077-0W | October 27, 2016 |
| Hassenfratz, Thomas A. | Buffalo | P02071-9B | October 27, 2016 |
| Hausle, John C. | Hilton | 128290-4W | October 27, 2016 |
| Hayt, David B. | New York | 080080-5W | October 27, 2016 |
| Hustad, Kent Owen | Syracuse | 152980-9W | October 27, 2016 |
| Ignacio, Adelfino S. | Staten Island | 159264-1W | October 27, 2016 |
| Jolly, George A. | Middle Grove | 127194-9W | October 27, 2016 |
| Kajubi, Samuel Kulumbavo | New Rochelle | 166884-7B | October 27, 2016 |
| Kaloyanides, George J. | Stony Brook | 090736-0W | October 27, 2016 |
| Kalt, Wallace Bill | New York | 077178-2W | October 27, 2016 |
| Katari, Venkata Subrahmanyeswara | South Salem | 146807-3W | October 27, 2016 |
| Kearns, Kenneth Aaron | Merrick | 266349-0W | October 27, 2016 |
| Keirns, Carla Christine | Stony Brook | 253334-7B | October 27, 2016 |
| Kirshenbaum, Richard I. | Brooklyn | 083196-6W | October 27,2016 |
| Klein, Robert E. | Brossard | C01921-6B | October 27, 2016 |
| Kramer, Albert Seymour | Lloyd Harbor | 071380-0W | October 27, 2016 |
| Kramer, Paul | Bellmore | 096896-6W | October 27, 2016 |
| LaFountain, Richard B. | Williamsville | 138706-7W | October 27, 2016 |
| Laieta, Daniel A. | Holbrook | P02401-8B | October 27, 2016 |
| Lau, Anthony Ching Kwok | Monroe | 114627-3W | October 27, 2016 |
| Lee, Soo Duk | Goshen | 126793-9W | October 27, 2016 |
| Lerner, Barry | Middletown | P03054-4B | October 27, 2016 |
| Lowe, Phillip Alan | Auburn | 165303-9W | October 27, 2016 |
| Lowenstein, Robert Ernest | Deansboro | 138551-7W | October 31, 2016 |
| Mahoney, Paul D. | Johns Island | 099792-4I | October 27, 2016 |
| Mainolfi, Maria Bernadette | Horseheads | 266134-6W | October 27, 2016 |
| Marzziotti, Robert John | Eastchester | 086658-2W | October 27, 2016 |
| Masrani, Deepa | Jamesville | L03325-8W | October 27, 2016 |
| Mellon, Matthew Birk | Massapequa | 261768-6W | October 27, 2016 |
| Mescon, Marilee D. | New York | 132351-8B | October 27, 2016 |
| Milder, Emanuel | Brooklyn | 078179-9W | October 27, 2016 |
| Miraglia, Alexander J. | Brooklyn | P02216-0W | October 27, 2016 |
| Molomot, Leslie J. | Fishkill | C00909-2W | October 27, 2016 |
| Muchnick, Richard Stuart | New York | 101375-4B | October 27, 2016 |
| Nelligar, Steven V. | New York | C06875-9B | October 27, 2016 |
| Nichols, John Edwin | Canandaigua | 184779-7W | October 27, 2016 |
| Nogrady, Judd | Montgomery | C08124-0B | October 27, 2016 |
| Ortiguera, Jose M. | Westbury | 111478-4W | October 27, 2016 |
| Pechenik, Boris | Buffalo | 206701-5W | October 27, 2016 |
| Reichbach, Steven | Melville | 195068-2W | October 27, 2016 |
| Reilly, Kevin B. | Mt. Kisco | 109025-7W | October 27, 2016 |
| Replogle, Robert Edward | Rochester | 259529-6W | October 27, 2016 |
| Siegler, David | Hastings on the Hudson | 148740-4W | October 27, 2016 |
| Sollazzo, Richard | Nissequoque | C02456-2I | October 27, 2016 |
| Spenser, Ciprian Raoul | Chino | 242705-2W | October 27, 2016 |
| Surya, Gerald | New Hyde Park | 204213-3W | October 27, 2016 |
| Szeremeta, Wasyl | Plainview | 258074-4W | October 27, 2016 |
| Trinidad, John R. | East Northport | P02883-7W | October 27, 2016 |
| Wallis, Lila Amdurska | Rhinebeck | 073742-9W | October 27, 2016 |
| Walsh, George Francis, Jr. | Pittsford | 097410-5W | October 27, 2016 |
| Yudell, Gerald Irving | Mt. Vernon | 084508-1W | October 27, 2016 |
| Yurt, Roger W. | New York | 130553-1W | October 27, 2016 |
* Providers authorized to treat only, have an authorization number ending in "W" – Providers authorized to treat and perform independent medical examinations, have an authorization number ending in "B" – Providers authorized to perform independent medical examinations only, 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.
Kenneth J. Munnelly
Chair