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Subject Number 046-934 Changes to the List of Health Care Providers Authorized to Render Services to Injured Workers Under the Workers' Compensation Law

Subject Numbers Regarding Health Provider Authorizations

April 19, 2017

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.

Aguilar, David Emil Austin C11576-8B February 14, 2017
Ahmed, Naeem Staten Island 140418-5W February 14, 2017
Alba, Augusta Strongman Massapequa 073634-8W February 14, 2017
Baxi, Rashmikant Kantilal Roslyn 135851-4W February 14, 2017
Bohan, Joseph P. Olean 119943-9W February 14, 2017
Boxhill, Agnes M. Lewes 142451-4W February 14, 2017
Brigandi, Angelo Ronald Rochester 087040-2W February 14, 2017
Brown, Charles S. Thompson Ridge C00036-6B February 14, 2017
Carroll, David F. Norwood C10955-5I February 15, 2017
Cedarbaum, David Paul Ithaca C05308-4B February 15, 2017
Deangelis, Richard Anthony Valley Stream C06905-6B February 15, 2017
Deutsch, Frederic H. New York 072768-5W February 15, 2017
Dewar, Kate Marie Elmira 261011-1W February 15, 2017
Distenfeld, Ariel New York 080901-2B February 15, 2017
Dyro, Frances Mary West Roxbury 110985-9W February 15, 2017
Ellenbogen, David Jason Commack P06125-0W February 15, 2017
Eppley, Suzanne Margaret Salem 143465-3W February 15, 2017
Fagan, James M. Cooperstown 113405-5B February 15, 2017
Farman, Jack Great Neck 102731-7W February 15, 2017
Fast, Avital Brooklyn 167979-4B February 15, 2017
Fathalla, Mahmoud F. Norwich 200069-3B February 16, 2017
Flannigan, Thomas A. Little Neck C05661-6W February 16, 2017
Flores, Lamberto V. Staten Island 126185-8W February 16, 2017
Greenberg, Henry Morton New York 101067-7W February 16, 2017
Hlaing, Thinn Great Neck 253420-4B February 16, 2017
Jagoda, Joshua Barry White Plains C11956-2B February 16, 2017
Jayagopal, Sharada E Williston 151424-9W February 16, 2017
Kam, Joseph J. Buffalo C00845-0W February 16, 2017
Kazdin, Hal J. Brooklyn 145170-7W February 16, 2017
Klebanov, Roman Brooklyn 151364-7W February 16, 2017
Koppel, Neil J. Naples C08178-8B February 16, 2017
Lucia-Russell, Robin Mount Vernon C04166-7W February 16, 2017
Mahdavian, Jalal Kingston 097334-7W February 16, 2017
Mantena, Raju Madhav Murali Roslyn Heights 227337-3W February 16, 2017
Marvel, Matthew Edgar Syracuse 173411-0W February 17, 2017
Mazza, Michael Angelo Spencerport 082768-3W February 17, 2017
Mehrotra, Vishnu G. Troy 129891-8W February 17, 2017
Mustapha, Rahma Marikar Valatie 123180-2B February 17, 2017
Nassoiy, Elisa Lynn Grand Island C11954-7W February 17, 2017
Nguyen, Binh Nhu Bayside C10471-3B February 17, 2017
Occhino, Frederick Michael Estero 108941-6B February 17, 2017
Panner, Bernard J. Rochester 084849-9W February 17, 2017
Patil, Kashinath B. Pittsford 107458-2W February 17, 2017
Peck, Rochelle L. New York 153620-0W February 21, 2017
Perumal, Subramanian Bronx 119300-2W February 21, 2017
Pincus, Martin Mark New York 127900-9B February 21, 2017
Prior, Mark Christopher Depew C10264-2B February 21, 2017
Ramos, Raul Alejandro Rock Hill 221370-0W February 21, 2017
Resurreccion, Ernesto C. Belle Harbor 111541-9W February 21, 2017
Riaz, Aasma Middletown 270211-6W February 22, 2017
Rissacher, Tred John Stuart C05519-6B February 22, 2017
Rovelli, Paul Mario Deer Park S13722-4B February 22, 2017
Sarakhun, Chalermpong New York 118443-1B February 22, 2017
Schively, Dora Hammar Salisbury 104268-8W February 22, 2017
Selina-Segal, Natalya Horseheads 236822-3W February 22, 2017
Serpe, Salvatore John Amityville 080529-1B February 22, 2017
Shah, Kokila B. Jericho 153741-4W February 22, 2017
Shalit, Shimon Harrison 095582-3W February 22, 2017
Valente, Domenico Plainview 121883-3W February 22, 2017
Sifontes, Lionel Anthony Buffalo 103484-2W February 22, 2017
Sunwoo, Moon Hartsdale 107723-9W February 22, 2017
Troncoso, Raudo Antonio Mount Kisco 105023-6W February 22, 2017
Ungar, Heidi Elizabeth New York 272864-0W February 22, 2017
Van Dine, Kenneth G. Wellsville 100546-1W February 23, 2017
Vivera, Arsenio B. New York 097625-8W February 23, 2017
Whelen, Barbara E. Patchogue C06680-5B February 23, 2017
Yiannou, James Yonkers 087350-5W February 23, 2017
Zalmanov, Mikhail I. Rego Park 158429-1W February 23, 2017
Zimberg, Sheldon New York 087798-5W February 23, 2017

* 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