COUNTY NEW YORK STATE WORKERS' COMPENSATION ...

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PODIATRISTS
LICENSE # Treat IME
Adler Steven Philip P04531-1 W 6/2/1992
DPM
Pearl River NY 10965-2057 004531
Baldinger Harry G P02930-7 W 10/21/1980
DPM
Monsey NY 10952-1703 002930
Baskin Howard Franklyn P02350-8 W 12/8/1998
DPM
Spring Valley NY 10977-3702 002350
Bernstein Ira P05869-4 B 5/12/2003 5/12/2003 DPM
Bardonia NY 10954-2042 005869
Conenello Robert Michael P04796-0 B 1/29/1996 7/12/2001 DPM
Orangeburg NY 10962-4102 004796
Costa Peter P03910-8 W 1/29/1996
DPM
Stony Point NY 10980-2400 003910
Fessel Steven E P02847-3 W 5/1/1980
DPM
Nanuet NY 10954-2884 002847
Fischman Gary Joseph P02456-3 W 1/16/1981
DPM
Monsey NY 10952-2260 002456
Friedman Howard Evan P05263-0 B 8/28/2003 8/28/2003 DPM
Suffern NY 10901-4221 005263
Garber Jaime Lyn Benincasa P06286-0 B 4/20/2009 4/20/2009 DPM
West Nyack NY 10994-2220 006286
Garbus Gary L P03735-9 B 12/4/1985 5/15/2001 DPM
Spring Valley NY 10977-4913 003735
Ginsburg Michael M P05785-2 B 5/9/2003 5/9/2003 DPM
Spring Valley NY 10977-1121 005785
Helman Jay D P02496-9 B 7/29/1974 6/4/2002 DPM
Pearl River NY 10965-1296 002496
Horowitz Jeffrey Robert P05741-5 B 8/12/2004 8/12/2004 DPM
Pomona NY 10970-3560 005741
Kleinman Richard Douglas P03099-0 W 10/3/1997
DPM
New City NY 10956-4132 003099
Leibert Stewart I P02256-7 W 3/18/1969
DPM
Airmont NY 10952-4924 002256
Leshen Stanley B P01858-1 W 2/28/1957
DPM
Suffern NY 10901-6019 001858
Levine Jay Gary P04113-8 B 1/12/1990 11/27/2001 DPM
Nanuet NY 10954-2452 004113
Mittler Barbara Ellen P03273-1 B 10/20/1982 5/15/2001 DPM
Pearl River NY 10965-1234 003273
Pinker Bruce Steven P05794-4 B 3/8/2005 3/8/2005 DPM
Pomona NY 10970-3512 005794
Rodin Bruce Michael P02339-1 W 3/15/1977
DPM
New City NY 10956-5262 002339
* - Indicates that the provider is new this month
SPECIALTY
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 1 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PODIATRISTS
LICENSE # Treat IME
Schoenberg Barry J P02983-6 W 10/27/1980
DPM
Pomona NY 10970-3560 002983
Sliva Renee P05490-9 W 7/18/2000
DPM
Nyack NY 10960-2482 005490
Spivack Joel L P02626-1 W 4/5/1976
DPM
Pomona NY 10970-3512 002626
Steiner Joseph George P02390-4 W 2/26/1974
DPM
Congers NY 10920-2622 002390
Subik Michael P05688-8 I 8/28/2003 DPM
Pearl River NY 10965-1234 005688
Wolff Charles Jonathan P04857-0 B 11/25/1991 7/12/2001 DPM
West Nyack NY 10994-2220 004857
* - Indicates that the provider is new this month
SPECIALTY
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 2 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PSYCHOLOGISTS
LICENSE # Treat IME
Aiello Thomas John S03218-5 B 3/11/1992 11/13/2002 PSY
New City NY 10956-2313 003218
Alvarez Margaret B S11448-8 W 5/28/1994
PSY
Pomona NY 10970-3600 011448
Barowsky Ellis I S04905-6 W 8/31/1993
PSY
Pomona NY 10970-3560 004905
Castro Nadine B S08856-7 W 3/12/1996
PSY
Nyack NY 10960-1002 008856
Christos Constantine S04172-3 W 2/27/1998
PSY
New City NY 10956-5724 004172
Drassner David Joel S07244-7 W 8/9/1991
PSY
New City NY 10956-6011 007244
Groth George H W S08394-9 W 5/28/1994
PSY
Valley Cottage NY 10989-0265 008394
Heller Charles Harris S06642-3 W 7/14/1992
PSY
Monsey NY 10952-1413 006642
Kogen Jonathan Bernard S03552-7 B 8/9/1991 12/31/2003 PSY
Blauvelt NY 10913- 003552
Koretsky Stephen M S09372-4 B 11/6/1991 11/5/2001 PSY
Pomona NY 10970-3530 009372
Lowenstein Bruce H S10124-6 W 6/1/1994
PSY
New City NY 10956-1004 010124
Matiatos Irene S10778-9 B 9/24/1996 5/31/2001 PSY
Nanuet NY 10954-2454 010778
Neffinger George Gail S04493-3 B 6/24/1994 5/31/2001 PSY
Nyack NY 10960-1007 004493
Quittman Stephen Ashley S03744-0 B 5/7/1998 3/20/2001 PSY
New City NY 10956-5302 003744
Safran Stephen B S06421-2 B 8/9/1991 11/5/2001 PSY
Nyack NY 10960-4701 006421
Schroeder Karen E S11650-9 W 7/23/1997
PSY
Suffern NY 10901-3742 011650
Smith Maureen B S05781-0 W 1/23/1998
PSY
New City NY 10956-5729 005781
Trachter Amy Beth S15934-3 W 8/15/2012
PSY
Nyack NY 10960-4826 015934
Waldbaum Jewell Kriegel S03934-7 B 10/30/1996 3/30/2001 PSY
Chestnut Ridge NY 10977-6104 003934
Witte Sally Schaum S10529-6 W 1/27/1993
PSY
Nyack NY 10960-4503 010529
Zacker Joseph W S03939-6 B 12/31/1991 3/20/2001 PSY
Pomona NY 10970-2014 003939
* - Indicates that the provider is new this month
SPECIALTY
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 3 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PSYCHOLOGISTS
LICENSE # Treat IME
Zweig Joseph B S06816-3 W 10/7/1993
PSY
Pomona NY 10970-3560 006816
* - Indicates that the provider is new this month
SPECIALTY
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 4 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
CHIROPRACTORS
LICENSE # Treat IME
Allonce Daniel Jean-Baptiste C10722-9 W 8/19/2004
DC
Spring Valley NY 10977-5613 010722
Askenas Todd Bradley C06837-1 B 2/24/1992 3/20/2001 DC
Pearl River NY 10965-2318 006837
Bambara Paul C02904-3 B 4/15/1982 3/20/2001 DC
West Nyack NY 10994-1847 002904
Blank Kenneth Neil C10842-5 B 8/17/2005 8/17/2005 DC
Montebello NY 10901-4157 010842
Bloom Richard M C04668-2 W 4/21/1987
DC
Chestnut Ridge NY 10977-7049 004668
Blum Franklin Ernest C01585-1 W 6/7/1974
DC
Airmont NY 10952-4533 001585
Bonnett Robert Thomas Jr C05937-0 B 3/5/1990 3/20/2001 DC
Spring Valley NY 10977-5741 005937
Caminez Brett Aaron C10418-4 W 6/12/2002
DC
West Nyack NY 10994-1840 010418
Cappello Renato M C11114-8 B 12/27/2005 12/27/2005 DC
Spring Valley NY 10977-3702 011114
Carbone Sue Robin C03721-0 W 8/14/1984
DC
Suffern NY 10901-3931 003721
Cocilovo Michael Charles C04589-0 B 1/22/1988 3/20/2001 DC
New City NY 10956-5272 004589
Colarusso David C08464-2 W 7/21/2000
DC
West Haverstraw NY 10993-1031 008464
Daccardi John L C01721-2 W 6/7/1974
DC
Stony Point NY 10980-0660 001721
Decarlo Christopher J C10596-7 W 2/1/2005
DC
New City NY 10956-1343 010596
Del Principio Donna Marie C06298-6 B 11/1/1990 3/20/2001 DC
Stony Point NY 10980-3653 006298
Delisi John Robert C11091-8 W 2/9/2006
DC
Pomona NY 10970-3559 011091
Denoia Joseph C02407-7 W 4/7/1981
DC
New City NY 10956-6256 002407
Diamond Stephen L C00083-8 W 7/18/1974
DC
Spring Valley NY 10977-6603 000083
Dicostanzo Vincent John C02720-3 W 1/15/1982
DC
Tappan NY 10983-1242 002720
Downs Lisa Anne C07522-8 B 9/17/1994 4/2/2001 DC
Pearl River NY 10965-1339 007522
Dunn Bernadette Theresa C07982-4 W 12/1/1995
DC
Stony Point NY 10980-2311 007982
* - Indicates that the provider is new this month
SPECIALTY
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 5 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
CHIROPRACTORS
LICENSE # Treat IME
Esposito Raymond Gregory C07455-1 B 6/29/1994 3/20/2001 DC
Nyack NY 10960-4636 007455
Ferrante Ralph Mario C02640-3 W 9/25/1981
DC
Nyack NY 10960- 002640
Ferraro Mark Thomas C02429-1 B 11/20/1980 4/20/2001 DC
Stony Point NY 10980-2400 002429
Florio Joanne C04810-0 W 3/1/1988
DC
Airmont NY 10952-4815 004810
Forgacs Lawrence David C02846-6 W 2/11/1982
DC
Tappan NY 10983-2419 002846
Freeley Mary Theresa C11020-7 W 8/1/2005
DC
Suffern NY 10901-4156 011020
Friedman Lynn Carla C05818-2 W 1/12/1990
DC
Pomona NY 10970-3525 005818
Gjelsten Joanne Terese C08140-8 W 4/20/1996
DC
Monsey NY 10952-5204 008140
Goldman Eric C03553-7 W 8/1/1984
DC
Pomona NY 10970-2922 003553
Goldsmith Neal Samuel C10664-3 W 7/29/2004
DC
New City NY 10956-7003 010664
Goldstein Michael I C03875-4 B 5/19/1986 4/20/2001 DC
Monsey NY 10952-1653 003875
Greany Michael Philip C05515-4 B 9/6/1989 4/3/2001 DC
Spring Valley NY 10977-3702 005515
Gregory James J C07332-2 W 7/22/1994
DC
Nanuet NY 10954-2510 007332
Gregory Richard John C06767-0 W 1/6/1992
DC
Nanuet NY 10954-2510 006767
Gregory Robert A D C00136-4 W 10/18/1974
DC
Nanuet NY 10954-2510 000136
Gregory Robert M D C05267-2 W 12/6/1990
DC
New City NY 10956-2813 005267
Grosso William M C02597-5 W 9/29/1981
DC
New City NY 10956-3040 002597
Guglielmucci John Victor C07529-3 B 9/17/1994 4/2/2001 DC
Pearl River NY 10965-1339 007529
Haggerty Kevin Michael C05516-2 B 11/1/1990 4/3/2001 DC
Spring Valley NY 10977-3702 005516
Handelsman Bruce N C03343-3 B 8/23/1983 3/20/2001 DC
Nyack NY 10960-2623 003343
Handt Joshua Lee C11296-3 W 4/29/2010
DC
New City NY 10956-2468 011296
* - Indicates that the provider is new this month
SPECIALTY
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 6 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
CHIROPRACTORS
LICENSE # Treat IME
Hennessy Diane Clare C05349-8 B 5/17/1991 6/8/2001 DC
Nanuet NY 10954-2510 005349
Hilario Alex C10986-0 B 4/26/2006 4/26/2006 DC
Sloatsburg NY 10974-0172 010986
Hilley John P C04653-4 W 4/8/1988
DC
Stony Point NY 10980-2337 004653
Holt Brian P C01932-5 B 6/15/1977 6/8/2001 DC
Pearl River NY 10965-1295 001932
Hyman Ronny Howard C05960-2 B 3/5/1990 3/20/2001 DC
Spring Valley NY 10977-5741 005960
Jagoda Joshua Barry C11956-2 B 4/26/2011 4/26/2011 DC
Valley Cottage NY 10989-1310 011956
Johnson Lance Arlington C06826-4 B 11/26/1997 3/20/2001 DC
New City NY 10956-5302 006826
Johnson William Ronald C08833-8 W 12/30/1998
DC
Nanuet NY 10954-3325 008833
Joseph Raymond G C03919-0 B 5/28/1987 4/3/2001 DC
New City NY 10956-3605 003919
Katz Brian E C00848-4 B 6/11/1974 3/20/2001 DC
Spring Valley NY 10977-2910 000848
Katzburg-Geffen Yona C05610-3 W 1/12/1990
DC
New City NY 10956-2713 005610
Kaufer Arthur Max C05963-6 B 1/12/1990 3/20/2001 DC
Suffern NY 10901-4906 005963
Kaufer David H C06211-9 B 9/5/1990 3/20/2001 DC
Suffern NY 10901-4906 006211
Kaufer Marshall C00178-6 W 6/11/1974
DC
Suffern NY 10901-4906 000178
Klayman David Marshall C08738-9 B 3/23/1998 3/20/2001 DC
Blauvelt NY 10913-1105 008738
Klein Phillip C06276-2 W 8/20/1991
DC
Pomona NY 10970-3529 006276
Kotorac James Peter C05083-3 W 11/17/1987
DC
Valley Cottage NY 10989-2534 005083
Landi Ernest Francis C01769-1 W 2/7/1975
DC
Chestnut Ridge NY 10977-6222 001769
Lauro Anthony Padua C06078-2 W 2/22/1993
DC
Pomona NY 10970-0005 006078
Lauro Frederick John C01467-2 W 6/11/1974
DC
Pomona NY 10970- 001467
Leichter Mark Fredric C07465-0 B 12/14/1993 3/20/2001 DC
Stony Point NY 10980-2729 007465
* - Indicates that the provider is new this month
SPECIALTY
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 7 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
CHIROPRACTORS
LICENSE # Treat IME
Lentini Paul Michael C07536-8 B 5/3/1994 3/20/2001 DC
Bardonia NY 10954-2123 007536
Leroy Anthony J C05559-2 W 12/16/1988
DC
Nanuet NY 10954-2454 005559
Littman Ralph Melvin C00216-4 B 6/7/1974 3/20/2001 DC
Monsey NY 10952-3761 000216
Lupi James Dario C07130-0 B 11/8/1994 3/20/2001 DC
Stony Point NY 10980-2450 007130
Marvin Kenneth Russell C08559-9 B 9/26/1997 3/20/2001 DC
Pearl River NY 10965-2306 008559
Mathew Mariyam Bindu K C11452-2 B 6/24/2011 6/24/2011 DC
Bardonia NY 10954-2026 011452
McAllister James Maurice C05373-8 B 5/10/1989 3/20/2001 DC
Pearl River NY 10965-2533 005373
Monks James Joseph C11289-8 W 6/30/2010
DC
Chestnut Ridge NY 10977-7019 011289
Morris Cheryl L C09837-8 W 5/23/2001
DC
Nyack NY 10960-4423 009837
Mykalcio Lauren T C10590-0 W 1/7/2005
DC
New City NY 10956-1343 010590
Nugent Craig Timothy C11438-1 W 1/20/2009
DC
New City NY 10956-5000 011438
Numeroff Bruce Aaron C05706-9 W 1/24/1990
DC
Pomona NY 10970-3512 005706
O'Brien Joseph C09128-2 W 2/14/2000
DC
Suffern NY 10901-5416 009128
Pavia Ronald Anthony C08287-7 B 11/25/1996 3/20/2001 DC
New City NY 10956-3130 008287
Petersen Robert Peter C02347-5 W 3/21/1980
DC
West Nyack NY 10994-1848 002347
Piperni Franca L C04857-1 B 6/24/1987 4/3/2001 DC
Nyack NY 10960-1807 004857
Ratsprecher Brad C10186-7 B 11/16/2001 11/16/2001 DC
Montebello NY 10901-4157 010186
Rodriguez Gilbert A C12113-9 W 3/16/2012
DC
New City NY 10956-5272 012113
Rosenthal William Joseph C08878-3 B 6/25/1998 3/20/2001 DC
Suffern NY 10901-4907 008878
Roy Peter G C06287-9 W 11/1/1990
DC
Grand
View-On-Hudson
NY 10960-4906 006287
Rubino John N C10368-1 W 6/24/2011
DC
West Nyack NY 10994-1966 010368
* - Indicates that the provider is new this month
SPECIALTY
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 8 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
CHIROPRACTORS
LICENSE # Treat IME
Rush Stephen H C06239-0 B 1/4/1996 4/3/2001 DC
Stony Point NY 10980-2743 006239
Russo Randolph Joseph C08265-3 W 10/29/1996
DC
Bardonia NY 10954-2123 008265
Russo Roger A C02602-3 W 1/15/1982
DC
Congers NY 10920-1425 002602
Scarpulla Charles Anthony C10012-5 W 7/11/2001
DC
Orangeburg NY 10962-1353 010012
Schettini Yegues C06555-9 W 4/11/1991
DC
Spring Valley NY 10977-5678 006555
Schnapper Jeffrey S C05831-5 B 11/3/1989 4/3/2001 DC
Bardonia NY 10954-2049 005831
Schwartz Jay C03011-6 B 4/15/1982 3/20/2001 DC
Pomona NY 10970- 003011
Sobieraj Agnes Mazzella C03020-7 W 9/29/1982
DC
New City NY 10956-2217 003020
Strauss Andrew C03294-8 B 12/3/2002 12/3/2002 DC
Nanuet NY 10954-2234 003294
Striano Richard D C03043-9 W 10/5/1983
DC
Suffern NY 10901-5217 003043
Suchoff Lawrence J C02457-2 B 10/14/1980 3/20/2001 DC
New City NY 10956-1002 002457
Taffuri Vincent M Jr C03022-3 W 1/3/1983
DC
Airmont NY 10952-3835 003022
Trager Donald Roger C01237-9 W 9/18/1979
DC
Monsey NY 10952-1641 001237
Trinkoff Paul Michael C05420-7 B 6/2/1989 3/20/2001 DC
Orangeburg NY 10962-2188 005420
Turner Eva Grace C07051-8 W 8/20/1992
DC
Orangeburg NY 10962-2827 007051
Weiner Randy C03516-4 B 12/12/1983 3/20/2001 DC
New City NY 10956-3036 003516
Weinstein Chad Michael C10827-6 W 9/12/2008
DC
Goshen NY 10924-1405 010827
Williamson Jeanne M C05887-7 W 10/24/1989
DC
Stony Point NY 10980-2337 005887
* - Indicates that the provider is new this month
SPECIALTY
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 9 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
SPECIALTY
Abdul-Quader Mohammed 128939-6 W 10/13/1993
CR-DRA
Orangeburg NY 10962-1908 128939
Adams George L 135903-3 W 5/18/1984
CU
Spring Valley NY 10977-5255 135903
Adaniel Tindalo R A 110839-8 W 10/30/1972
CS
Orangeburg NY 10962-2109 110839
Agarwal Arvind Kumar 181950-7 W 2/4/1991
CIM-CVD
Stony Point NY 10980-2400 181950
Ahluwalia Madhu B 136052-8 W 11/5/1998
CPN-P
Pomona NY 10970-3559 136052
Akkapeddi Sudha Lakshmi 205629-9 W 2/24/1998
CPMR
Blauvelt NY 10913-1247 205629
Allyne Louis Jay 162672-0 W 4/3/1989
AN
New City NY 10956-6657 162672
Aminullah Mohammad 185905-7 W 1/8/1999
CIM
Nanuet NY 10954-3328 185905
Antar Koshnaf Alan 219104-7 W 5/27/2008
CIM
New City NY 10956-6909 219104
CIM-RHE
Appel Arthur Erwin 112923-8 W 11/19/1976
CIM
Pearl River NY 10965-2510 112923
CIM-NEPH
Aronwald Michael 130790-9 W 8/26/1977
IM
Suffern NY 10901-5005 130790
Arrigo John Cyrus 093866-2 W 7/6/1965
GP
Suffern NY 10901-3743 093866
Asch Thane 078978-4 W 7/27/1960
CR
Tappan NY 10983-1826 078978
Ashenofsky David 157072-0 W 9/23/1988
CIM
Tomkins Cove NY 10986-1003 157072
Astrove Charles Stephen 098884-0 W 12/24/1985
PN-P
Nanuet NY 10954-2532 098884
Austin Kenneth S 179160-7 B 12/10/1996 7/16/2001 COS
Airmont NY 10952-3420 179160
Avella Thomas Jay 232972-0 W 2/3/2006
CIM
Stony Point NY 10980-2400 232972
Aventuro Louis J 095901-5 B 6/3/1968 5/1/2001 CO
Garnerville NY 10923-1595 095901
Ayers Frederick P 171026-8 W 4/5/2002
CR-DRA
Suffern NY 10901-4812 171026
Baez Bernard Bartholome 222860-9 W 5/20/2008
CAN
Suffern NY 10901-5620 222860
Baron Marjorie Ellen 143589-0 W 2/1/1999
IM
West Haverstraw NY 10993- 143589
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 10 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Barr Paul S 073470-7 W 9/24/1962
CIM
Suffern NY 10901-3007 073470
Bartels Matthew Norbert 187331-4 W 3/14/1996
PMR
Palisades NY 10964-1513 187331
Battles E Deland Jr 083332-7 W 8/4/1966
CIM
Nyack NY 10960-4735 083332
Bavaro Nicholas Andre 211267-0 W 8/31/1999
OS
New City NY 10956-3049 211267
Becker Alfred 090954-9 W 8/28/1968
CIM
Suffern NY 10901-5273 090954
SPECIALTY
Bensman Michael S 109279-0 W 10/5/1981
CIM-CD
West Nyack NY 10994-1213 109279
Berezin Marc Andrew 167168-4 B 12/3/1993 4/2/2001 COS
Orangeburg NY 10962-2185 167168
Berkowitz Jessica Fuchs 163858-4 B 2/20/1992 4/23/2001 CR-DRA
Suffern NY 10901-5103 163858
Bernstein Ralph L 078216-9 W 4/4/1962
CAN
Suffern NY 10901-2304 078216
Bernstein Scott Alan 170189-5 B 2/5/1990 4/16/2001 CIM
Pomona NY 10970-3578 170189
Bernstein William Harvey 091619-7 W 4/23/1990
CP
New City NY 10956-3700 091619
Berson Bernard H 085104-8 W 6/25/1963
COL
Sloatsburg NY 10974-2644 085104
Berson Daniel 106055-7 W 8/3/1984
CS
New City NY 10956-2006 106055
Berson Shelley Rose 173585-1 W 5/27/1992
OL
West Nyack NY 10994-1847 173585
Beskyd Peter P 095394-3 W 4/17/1967
CPN-P
Nyack NY 10960-4906 095394
Bhatt Ghanshyam M 124987-9 W 7/12/1982
CR
Valley Cottage NY 10989-2212 124987
Bhattacharyya Arun Kumar 119036-2 W 10/16/1975
CPMR
New City NY 10956-6223 119036
Bierdumpfel-Bihari Linda Ida 169613-7 W 10/15/1996
IM
Monsey NY 10952-5217 169613
Bigman Alan Marc 139610-0 W 4/7/1987
EM
Piermont NY 10968-1085 139610
Birkett David Peter 105902-1 I 7/23/2001 CPN-P
Suffern NY 10901-3106 105902
Block Neil L 139859-3 W 3/8/1990
FP
Valley Cottage NY 10989-2701 139859
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 11 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
SPECIALTY
Blumberg Kenneth Ira 173263-5 W 9/3/1996
CR-DRA
New City NY 10956-5210 173263
Bobroff Lewis M 106056-5 W 10/16/1975
CR
Suffern NY 10901-4812 106056
Boris Jacob 088020-3 W 1/5/1987
CP
Tappan NY 10983-1603 088020
Bough Irvin David Jr 201905-7 I 3/2/2004 COL
West Nyack NY 10994-2229 201905
Brand Richard David 136448-8 W 10/1/1985
PN-P
Congers NY 10920-1904 136448
Brenner Robert J 116414-4 B 6/6/1978 4/2/2001 CO
New City NY 10956-3061 116414
Brief L Paul 094544-4 B 10/2/1978 4/23/2001 COS
Orangeburg NY 10962-2186 094544
Brief Rochelle 175033-0 B 8/17/1993 4/16/2001 CPMR
Bardonia NY 10954-2042 175033
Brogno David August 160631-8 W 2/4/1992
CIM-CVD
Suffern NY 10901-5208 160631
Brown-Berkowitz Suzanne 206543-1 W 12/1/2000
CR-DRA
New City NY 10956-5210 206543
Burns Paul 138423-9 W 2/6/1985
CAN
Suffern NY 10901-4927 138423
Butterman Marvin E 089261-2 W 3/15/1967
CU
Airmont NY 10952-3429 089261
Cantor Richard S 139400-6 B 3/18/1988 5/11/2001 CIM
Suffern NY 10901-8220 139400
CIM-CVD
Carlin Michael Lawrence 179507-9 W 11/6/1995
CR-DRA
West Nyack NY 10994-1608 179507
Carroll Deborah J 171520-0 W 9/28/1998
CPA-AP
Nyack NY 10960-5011 171520
CPA-CLP
Ceus Faidherbe 197802-2 W 10/1/2002
IM
Nanuet NY 10954-3010 197802
PN-P
Chan Jane Wai Wang 250318-3 W 4/3/2009
CR-DRA
New City NY 10956-5210 250318
Chang Benjamin Gee 221062-3 W 3/22/2007
CIM
West Nyack NY 10994-2220 221062
CIM-CCM
CIM-PD
Chang John Chu-Hong 225687-3 W 7/26/2004
O
Pearl River NY 10965-2057 225687
Chang Peter Youk-Twoo 171437-7 W 11/23/1993
CIM
Nanuet NY 10954-2454 171437
Chang Timothy Chen Wea 114416-1 W 4/8/1976
CS
West Nyack NY 10994-1306 114416
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 12 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Chen Robert 204955-9 W 10/4/2002
O
Garnerville NY 10923-1595 204955
Chen Yong 260065-8 B 7/19/2012 7/19/2012 CIM
Pomona NY 10970-3553 260065
SPECIALTY
Chen Yue Qiu 232649-4 W 1/18/2005
R-DRA
Suffern NY 10901-4927 232649
Citrome Leslie Lucien 170947-6 B 4/2/2001 4/2/2001 CPN-P
Suffern NY 10901-2307 170947
Clarkin Richard Patrick 176564-3 W 11/2/1992
CAN
Suffern NY 10901-4927 176564
Cohen Daniel Jonathan 154433-7 W 11/7/1986
CR-DRA
New City NY 10956-5210 154433
Cohen Zev Mark 180744-5 W 8/19/1992
IM
Nanuet NY 10954-1220 180744
Correa Hector L 102228-4 W 10/15/1969
CR
New City NY 10956-5210 102228
Cosman Felicia 161394-2 W 1/20/1999
CIM
West Haverstraw NY 10993- 161394
CIM-END
Costley-Hoke Karen M 164004-4 W 7/30/1992
IM
New City NY 10956-4305 164004
Cox George Robert 095164-0 W 10/27/1975
IM
Suffern NY 10901-4837 095164
Creech Charlotte Lynne 219459-5 B 10/17/2006 11/13/2002 CFP
Suffern NY 10901-8220 219459
Cricchio Frank Peter 188670-4 W 9/22/1992
FP
Pomona NY 10970-3530 188670
Dasari Srirama Krishnaiah 209480-3 W 9/20/1999
AN
Suffern NY 10901-5614 209480
Davis William L Jr 213531-7 W 9/20/1999
OS
Airmont NY 10952-3420 213531
Degen Jeffrey W 235754-9 W 8/24/2005
NS
Suffern NY 10901-5206 235754
Deschino Diane R 204969-0 W 1/25/1999
CIM
West Nyack NY 10994-2220 204969
Deutsch Evan Randolph 226548-6 W 1/15/2008
CS
Pomona NY 10970-3516 226548
Deutsch Joseph E 120473-4 B 3/26/1982 5/2/2005 COS
Pomona NY 10970-3516 120473
Dickinson P C Taylor 122936-8 W 4/15/1988
IM-ID
West Nyack NY 10994-2233 122936
Diner Martin K 180635-5 W 10/9/1992
CPM-OM
Tappan NY 10983-1917 180635
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 13 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Dubner Martin S 085113-9 W 12/29/1965
OG
Suffern NY 10901-3425 085113
SPECIALTY
Ducker Paul S 101731-8 W 10/20/1983
CPN-N
Suffern NY 10901-3818 101731
Dumlao Anacleta C 108405-2 W 7/2/1994
IM
Piermont NY 10968-1050 108405
Dumlao Themy L 108047-2 W 7/22/1971
CS
Piermont NY 10968-1050 108047
Dutkowsky Charles J 158930-8 W 9/2/1997
OPCPMR
Palisades NY 10964-1009 158930
Ecuyer Jean-Paul 242816-7 W 12/8/2008
CAN
Suffern NY 10901-4927 242816
Edelschick Donald Steven 138457-7 W 7/27/1984
CIM
New City NY 10956-1103 138457
Edelstein Richard 082562-0 W 4/27/1987
CIM
Orangeburg NY 10962-1019 082562
CIM-CVD
Eisen Louis Max 195200-1 W 10/14/2005
CR-DRA
New City NY 10956-5210 195200
Eisenberg Sarah M 214829-4 B 12/30/2003 12/30/2003 CIM
Monsey NY 10952-1209 214829
CP
Elazab Hany 218025-5 W 9/1/2000
AN
Suffern NY 10901-5517 218025
Eliazo Ethelwoldo E 130797-4 W 11/6/1993
R
Haverstraw NY 10927-2101 130797
Epelman Silvia Dolly 163898-0 W 4/15/2003
IM
New City NY 10956-1000 163898
Eriksen Roy H 119911-6 B 2/26/1985 4/16/2001 CIM
Nyack NY 10960-4425 119911
Facelle Thomas L 145054-3 W 9/28/1987
CS
Suffern NY 10901-4837 145054
Fagelman Mark 102803-4 B 8/9/1974 4/2/2001 CU
Pomona NY 10970-3559 102803
Fallah Ahmad Tafti 122334-6 W 9/3/1975
IM
Pomona NY 10970-2713 122334
Farcy Jean-Pierre Claude 156776-7 W 11/12/1985
OS
Piermont NY 10968-1221 156776
Feldman Sorrel Martin 096126-8 W 8/21/1979
CIM
New City NY 10956-4132 096126
Ferro Dominic Joseph 191385-4 B 9/11/2000 4/2/2001 CPN-P
Nanuet NY 10954-2425 191385
Fischer Eva 173175-1 W 5/15/2007
S
Suffern NY 10901-4917 173175
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 14 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Fishkind Deborah L 215224-7 W 4/22/2003
AN
Suffern NY 10901-5620 215224
SPECIALTY
Flax James W 124779-0 W 7/19/1996
CPN-P
Pomona NY 10970-3559 124779
Fleischer Lee Scott 175057-9 W 9/22/1992
S
West Nyack NY 10994-2229 175057
Fogelman Benjamin Gabriel 237710-9 W 12/6/2006
OPAN
Suffern NY 10901-5620 237710
Fogelman John Aaron 097682-9 W 2/20/1975
CPN-P
West Nyack NY 10994-1102 097682
Fond Jason E 203677-0 B 1/17/2002 1/9/2004 COS
Nanuet NY 10954-5288 203677
Frager David H 137887-6 W 3/5/1982
CR
Monsey NY 10952-1405 137887
Frey Roger Jay 174792-2 W 6/14/1996
CR-DRA
New City NY 10956-5210 174792
Frias Henry Anthony 198230-5 W 7/27/2000
IM
Nyack NY 10960-2731 198230
Fromm Stephen Robert 081633-0 B 8/15/1961 4/16/2001 CNS
Spring Valley NY 10977-5741 081633
Galante Michele Bruno 152652-4 W 3/4/1994
GP
Airmont NY 10901-7525 152652
Garcia Adelaida A 128557-6 W 3/29/1993
AN
New City NY 10956-6658 128557
Garigali Frank Xavier 154884-1 W 1/26/1993
IM
Nanuet NY 10954-2957 154884
Geller Mark Eli 173539-8 W 6/14/1996
CR-DRA
New City NY 10956-5210 173539
Gennaoui Nicolas 119467-9 W 1/27/1978
CS
Suffern NY 10901-4833 119467
Gill Harinder P 193037-9 W 7/29/1998
CIM
Nanuet NY 10954-2454 193037
Giraldo Jaime A 102517-0 W 1/2/1969
GP
Tappan NY 10983-1035 102517
Glajchen Neville 181812-9 W 10/8/1997
CR
New City NY 10956-5210 181812
Glassman Charles Frederick 167253-4 B 3/20/1990 4/2/2001 CIM
Pomona NY 10970-3516 167253
Glassman Lawrence S 139540-9 B 8/17/1987 4/2/2001 CPS
Nyack NY 10960-1627 139540
CS-HS
Goldberg Robert 143731-8 W 7/28/1995
CIM-ONCL
New City NY 10956-3336 143731
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 15 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
SPECIALTY
Golden Marianna 214403-8 I 4/5/2002 CPN-N
West Nyack NY 10994-2250 214403
Goldmark George M 120730-7 B 1/29/1980 2/11/2002 COS
New City NY 10956-3095 120730
Goldmark Harry 120598-8 B 11/19/1986 2/11/2002 COS
New City NY 10956-3095 120598
Goldstein Arthur D 090003-5 W 6/11/1965
CPS
Airmont NY 10952-3494 090003
Goldstein Monte Jay 176390-3 W 11/2/1992
CAN
New City NY 10956-6349 176390
Gordon Richard Nathaniel 198639-7 B 5/26/1998 4/23/2001 CO
Pomona NY 10970-3516 198639
Gottlieb Scott Lawrence 231296-5 W 6/18/2009
CAN
Suffern NY 10901-3137 231296
CAN-PM
Goumas William Marcus 170446-9 W 9/19/2006
CS
Suffern NY 10901-4837 170446
Greenbaum Stanley L 100540-4 W 1/24/1973
CIM
Suffern NY 10901-3601 100540
Grewal Neena 157707-1 W 7/10/1996
CIM
Stony Point NY 10980-2400 157707
Grewal Perminder S 157708-9 W 9/20/1990
CIM-CD
Stony Point NY 10980-2400 157708
Grinberg Carlos Santiago 110866-1 W 5/9/1972
CPA
New City NY 10956-2331 110866
Grinberg Daniel 217371-4 B 4/15/2003 4/15/2003 COL
West Nyack NY 10994-2222 217371
Grisafi Patrick Anthony 101744-1 W 4/2/1974
CO
Suffern NY 10901-4919 101744
Grodin Warren K 133869-8 W 7/24/1989
CAN
Valley Cottage NY 10989-1227 133869
Guha Sikha 145444-6 W 9/30/1981
PMR
New City NY 10956-5713 145444
Gurniak James Francis 187070-8 W 10/22/1992
IM
West Nyack NY 10994-6402 187070
Hafeez Mohammad 218392-9 W 3/16/2001
CIM
Suffern NY 10901-5006 218392
Haldorsen David 107113-3 W 1/27/1972
GP
Spring Valley NY 10977-3820 107113
Halevy-Avgush Rachel 173868-1 B 9/8/2005 9/8/2005 CIM
Garnerville NY 10923-1311 173868
Halle Steven Garry 160758-9 W 8/31/2001
CAN
New City NY 10956-5547 160758
CAN-PM
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 16 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
SPECIALTY
Handelsman Richard E 132553-9 B 7/12/1982 4/2/2001 OPCIM
Pomona NY 10970-3516 132553
Handler Elliot Victor 161811-5 W 12/11/1985
CR
New City NY 10956-5210 161811
Harris Leon S 135148-5 W 3/18/1988
CIM-PD
West Nyack NY 10994-2228 135148
Havriliak Damian John 175798-8 W 11/19/2009
CPS
Suffern NY 10901-8220 175798
PS-HS
Henson Elliot M 136678-0 W 11/20/1980
IM
Pomona NY 10970-3578 136678
Hirsch Cary L 143341-6 W 4/8/1985
CIM
Suffern NY 10901-4836 143341
CIM-CD
Hodes David L 127002-4 W 10/4/2002
CIM
West Nyack NY 10994-1966 127002
CIM-CCM
CIM-PD
Holland Robert D 247528-3 W 5/16/2008
PMR
West Haverstraw NY 10993- 247528
Hollander Alfred C 143954-6 W 6/16/1987
CIM-GE
Pomona NY 10970-3520 143954
Holliday Roy A 156798-1 W 10/21/1998
CR-DRA
Nyack NY 10960-1612 156798
Horng Jack Wei-Sen 206369-1 W 10/4/2002
CIM
West Nyack NY 10994-2220 206369
CIM-PD
Huang John Jan 213638-0 I 3/2/2004 COL
West Nyack NY 10994-2229 213638
Hurst Stephen Gerard 182239-4 W 8/26/2005
CS
Suffern NY 10901-4917 182239
CS-GVS
Hutchinson John E 3d 092795-4 W 11/19/1964
CS
Nyack NY 10960-5009 092795
CTS
Ibelli Vincent Marc 167148-6 W 10/28/1988
CFP
Tappan NY 10983-2514 167148
Ilan Doron 210630-0 W 3/18/2004
OS
New City NY 10956-3049 210630
Ingrassia Joseph T 128583-2 W 3/8/1979
CFP
Nanuet NY 10954-3093 128583
Isidro Jose Ramos Jr 173057-1 W 4/17/2012
GP
Suffern NY 10901-5207 173057
Israel James Benjamin 108902-8 W 7/30/1980
CIM
Suffern NY 10901-5204 108902
Israel Robert Joseph 156732-0 W 9/11/1987
CIM
Suffern NY 10901-3957 156732
Jablonski Robert Daniel Jr 180911-0 W 10/5/1995
PS
Pearl River NY 10965-2403 180911
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 17 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Jara Fernando A 163604-2 W 12/4/1990
EM
Tappan NY 10983-2416 163604
Josef Jeffrey Michael 166680-9 W 1/28/1993
CO
Pomona NY 10970-3521 166680
Kalvert Michael Alan 103700-1 W 4/15/1982
CPS
New City NY 10956-3061 103700
Kaminer Evan Marc 189747-9 W 7/29/1998
CR
New City NY 10956-5210 189747
Kane Neal David 166569-4 W 7/22/1992
CIM
Nyack NY 10960-5011 166569
SPECIALTY
Karetnick Gerald David 230166-1 W 8/26/2009
OPCFP
Nanuet NY 10954-3093 230166
Katz S Sheldon 075288-1 B 8/30/1961 12/11/2001 CNS
West Nyack NY 10994-2828 075288
Katz-Gerrish Julie Bek 203619-2 W 9/25/1997
OPCFP
West Nyack NY 10994-2116 203619
Kaufman Jody Lance 199979-6 W 7/16/1998
OPAN
Suffern NY 10901-3956 199979
Khafif Rene 091233-7 W 10/26/1964
CS
Suffern NY 10901-7016 091233
Kim Jae Chan 117579-3 W 11/27/1985
CS
Nyack NY 10960-4911 117579
King Marjorie L 146900-6 W 11/27/1996
CIM-CVD
West Haverstraw NY 10993- 146900
IM-CD
King Richard W 130834-5 W 6/18/1982
CFP
Valley Cottage NY 10989-2019 130834
King Thomas Francis 169330-8 W 8/30/1990
CIM
Stony Point NY 10980-3608 169330
Kinkhabwala Mahesh 107953-2 W 4/30/1982
CR
New City NY 10956-6225 107953
Kipnis Steven S 134732-7 W 7/17/1982
CIM
New City NY 10956-3741 134732
Klein Mitchell L 148277-7 W 1/6/1987
CIM
Stony Point NY 10980-1641 148277
Klein Stephen Allen 151797-8 W 6/20/1984
CIM
Suffern NY 10901-5000 151797
Klein Steven Ira 150453-9 W 7/16/1987
CR-DRA
New City NY 10956-5210 150453
Kole Richard Lawrence 116895-4 W 6/25/1976
IM
Pomona NY 10970-3578 116895
Kollakuzhiyil Mary J 239114-2 W 8/10/2012
IM
Tappan NY 10983-1739 239114
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 18 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Kopelson Jeffrey Charles 173982-0 W 4/27/1989
FP
Suffern NY 10901-8218 173982
SPECIALTY
Korngold Jay Mitchell 222599-3 W 2/10/2004
PS
New City NY 10956-3501 222599
PS-HS
Korngold Louis 098842-8 W 4/28/1992
CPS
New City NY 10956-3501 098842
Kotlyar Yanina 204324-8 W 9/13/2000
IM
New City NY 10956-5272 204324
Kraushaar Barry Saul 191949-7 B 12/30/1996 4/16/2001 COS
Nanuet NY 10954-5288 191949
Kroll Richard 113529-2 W 10/7/1980
CU
West Nyack NY 10994-1965 113529
Kuan Carenia Julie 203892-5 W 12/29/2009
P
Piermont NY 10968-1127 203892
Kubik Richard John 099493-9 B 7/26/1974 2/11/2002 COS
New City NY 10956-3049 099493
Kukla Helena J 135559-3 W 3/15/2012
CPN-P
New City NY 10956-3743 135559
Kurtti Neal Damian 180952-4 W 12/7/1992
CAN
Suffern NY 10901-4927 180952
Kurucz Stefan 128630-1 W 5/21/1979
IM
Pearl River NY 10965-1296 128630
Laico Joseph P 092960-4 B 4/3/1979 3/28/2001 COS
New City NY 10956-3041 092960
Laitman Bernard Isaac 140010-0 W 1/15/1998
CIM
New City NY 10956-5262 140010
Lakhani Hiten K 201374-6 W 11/19/2009
CO
Bardonia NY 10954-1614 201374
Landau Arthur 133917-5 W 11/20/1980
IM
Pomona NY 10970-3562 133917
Lartigue Schubert 206087-9 W 11/10/1997
CFP
W Haverstraw NY 10993-1103 206087
Latino Kathleen Louise 178898-3 W 10/1/1997
CU
West Nyack NY 10994-1965 178898
Lawrence Scott 153194-6 W 10/22/1994
CPN-P
New City NY 10956-6273 153194
Leahy Mary Patricia 167116-3 W 12/18/1990
CIM
West Nyack NY 10994-2220 167116
Lee Yogsing C 121614-2 W 1/15/1998 4/2/2001 IM
New City NY 10956-1303 121614
Leen Jeffrey Scott 228130-1 W 5/11/2005
O
Garnerville NY 10923-1552 228130
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 19 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Lehv Levi Herschel 162242-2 W 9/14/1998
CIM
Monsey NY 10952-2404 162242
SPECIALTY
Leslie Denise 150715-1 W 1/20/1988
CR-DRA
Nyack NY 10960-1618 150715
Leung Euston Y 137871-0 W 11/2/1979
AN
New City NY 10956-5555 137871
Levin Mark 165212-2 W 10/22/1990
CIM-ONCL
Monsey NY 10952-1956 165212
Levine Donald Todd 142708-7 B 6/16/1987 6/20/2001 COL
Nyack NY 10960-2624 142708
Levine Marc J 147068-1 B 11/3/1986 2/11/2002 COL
West Nyack NY 10994-2229 147068
Lewy Robert M 124623-0 W 11/2/1979
CFP
Blauvelt NY 10913-1127 124623
Liberis George Nicholas 179480-9 W 11/1/1996
S
New City NY 10956-4132 179480
Liebergall David Alan 190962-1 B 1/23/1996 5/10/2001 CO
Suffern NY 10901-5206 190962
Liebergall Gordon S 084611-3 W 10/3/1962
CO
Suffern NY 10901-5207 084611
Liebling Melissa Schubach 178323-2 W 8/27/1993
R
Spring Valley NY 10977-2007 178323
Lifschitz Barry M 120953-5 W 7/27/1984
CIM-END
Pomona NY 10970-3516 120953
Lin Judy Chin-Yu 235858-8 B 8/23/2006 8/23/2006 CIM
Suffern NY 10901-5208 235858
Lo Susan Hyunjee 206998-7 W 6/27/2003
CAN
Suffern NY 10901- 206998
Lorah Jay Arthur 206787-4 W 11/9/1998
OPCFP
Pearl River NY 10965-1190 206787
Lutwak Seymour Harvey 138362-9 W 8/21/1984
CIM
Suffern NY 10901-6511 138362
CIM-CD
Mackey Robert F 134866-3 W 2/14/1983
CR
New City NY 10956-5210 134866
Magrill Robert A 155942-6 W 3/14/1997
CNUM
New City NY 10956-6349 155942
CR-DRA
Maisel Louis Martin 178980-9 W 11/25/1993
O
New City NY 10956-5232 178980
Marcus Joel A 129275-4 W 8/17/1988
CIM-CVD
Suffern NY 10901-2105 129275
Mark Samuel Neelakanth 160659-9 W 5/27/1993
EM
Nanuet NY 10954-3523 160659
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 20 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Mass Alain Mordechai 225181-7 B 9/7/2004 9/7/2004 CFP
Monsey NY 10952-3372 225181
Master Mumtaz Kaizer 159742-6 W 10/12/2000
COG
Nanuet NY 10954-3435 159742
SPECIALTY
Mathew Anna 169371-2 W 9/21/1995
CIM-ONCL
New City NY 10956-3336 169371
Matta Ayman Zaki Mounir 215965-5 W 10/2/2006
CO
Orangeburg NY 10962-2185 215965
Medici Mark Domenic 203016-1 W 10/18/1999
COS
West Nyack NY 10994-2226 203016
Medina Felix Anthony 212195-2 W 7/10/2000
AN
Suffern NY 10901- 212195
Mehta Raghunath Mal 105948-4 B 11/29/1971 6/5/2003 CPN-ADP
Tappan NY 10983-1117 105948
CPN-GER
CPN-P
Melcer Christopher Bradley 177156-7 W 10/3/2002
CIM
Suffern NY 10901-2311 177156
Melyokhin Igor 201747-3 W 9/20/1996
AN
Suffern NY 10901-4121 201747
Menitove Stephen M 134760-8 W 6/18/1985
CIM
West Nyack NY 10994-2228 134760
CIM-PD
Mercurio Paul K 131916-9 W 8/7/1981
IM
New City NY 10956-3419 131916
Meyappan Thiagarajan 163096-1 W 8/3/1988
CAN
Suffern NY 10901-4927 163096
Miller Dean Arthur 186665-6 W 4/23/2008
CIM
West Nyack NY 10994-2220 186665
Millos Rosana Teresita 234157-6 B 10/30/2006 10/30/2006 CIM
Pomona NY 10970-3553 234157
Mims Timothy Thomas 231723-8 B 10/25/2006 10/25/2006 CAN
Suffern NY 10901-4927 231723
CAN-PM
Mintah Joseph Kyei 193750-7 W 3/15/1994
IM
West Nyack NY 10994-0325 193750
Model Lawrence Marc 135753-2 B 6/22/1989 12/7/2001 CFP
Pomona NY 10970-3559 135753
Monaco Domenic Anthony 163085-4 W 4/18/1988
CFP
Valley Cottage NY 10989-2019 163085
Moody Yasmeen A 147355-2 W 6/2/1983
CS
New City NY 10956-2105 147355
Mouzakitis Paul Ulysses 195920-4 W 4/21/1999
CAN
West Nyack NY 10994-1142 195920
Muhlbauer David 229493-2 W 12/19/2006
AN
Suffern NY 10901-5614 229493
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 21 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Murray Patrick Joseph 249136-3 W 11/6/2008
OS
West Nyack NY 10994-2212 249136
Muschel Michael J 151329-0 W 3/9/1988
CIM
Suffern NY 10901-5208 151329
SPECIALTY
Nakazawa Hiroshi 093635-1 B 1/8/1999 4/18/2001 CPA-AP
Valley Cottage NY 10989-1437 093635
CPA-CLP
Nambiar Ramesh Sethuram 215176-9 W 8/16/2000
AN
Suffern NY 10901-3948 215176
Neiman Josef Harvey 072822-0 W 4/4/1961
CIM
New City NY 10956-4437 072822
Nekrich Robert Daniel 229912-1 W 3/17/2004
CR-DRA
New City NY 10956-4437 229912
Nemesdy Gabor 171583-8 W 12/17/1992
CAN
Palisades NY 10964-0552 171583
Newfield Philip 101931-4 W 1/5/1987
CP
Tappan NY 10983-1311 101931
Nieves Walter L 132973-9 B 3/25/1983 3/20/2001 CPN-N
Suffern NY 10901-5103 132973
Nossoughi Akbar A 095530-2 W 6/23/1966
COL
Suffern NY 10901-4710 095530
Notaristefano Luigia Gina 203453-6 W 6/18/1997
CIM
West Nyack NY 10994-6402 203453
Nunziata Bernard Richard 138761-2 W 4/24/1990
CO
Suffern NY 10901-4242 138761
Nurenberg Jeffry Raul 106141-5 W 6/8/1979
CPN-P
Pomona NY 10970-2203 106141
Oppenheim Jeffrey Sable 178719-1 B 7/12/1994 6/8/2001 CNS
Suffern NY 10901-5206 178719
Opperman Sheldon Barry 151396-9 W 3/8/1984
AN
New City NY 10956-2212 151396
Osei Clement Y 131915-1 W 3/18/1988
CIM-PD
West Nyack NY 10994-2228 131915
Ossip Leslie M 173546-3 W 9/3/1996
CR-DRA
New City NY 10956-5210 173546
Ovshayev Juliet 220616-7 W 7/29/2009
OPCFP
Monsey NY 10952-3369 220616
Pak Soo Mee 193902-4 W 2/11/2002
CO
New City NY 10956-3061 193902
Palestro Christopher J 132382-3 W 10/22/1998
CNUM
Spring Valley NY 10977-7202 132382
Palop Ricardo 121693-6 W 12/4/1974
CAN
Nyack NY 10960-5023 121693
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 22 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Panchacharam Winston V 115314-7 W 6/14/1978
CAN
Nanuet NY 10954-1039 115314
SPECIALTY
Paras Carol A 149899-7 B 9/23/1997 5/1/2001 CPN-P
Pearl River NY 10965-1189 149899
Parikh Smita Suhrid 210890-0 W 1/18/2002
CAN
New City NY 10956-6929 210890
Pasha Ghousia Jabeen 213057-3 W 3/6/2000
CIM
Suffern NY 10901-5006 213057
Patel Darshana Prakash 237142-5 W 1/10/2006
AN
Suffern NY 10901-5614 237142
Patel Prakash Nanubhai 224689-0 W 5/15/2003
CR-DRA
Suffern NY 10901-4812 224689
Paticoff Joshua Matthew 234358-0 W 8/28/2006
CAN
Suffern NY 10901-4927 234358
Pavell Jeff Richard 202584-9 W 12/4/1998
OPPMR
Bardonia NY 10954-1601 202584
Peck Harvey Martin 076256-7 W 7/28/1961
CR
Pomona NY 10970- 076256
Pellicone John T 150985-0 B 11/26/1991 4/23/2001 CIM
West Haverstraw NY 10993-1195 150985
CIM-CCM
CIM-PD
Pelzig Naomi 146693-7 W 3/10/1995
GP
Nyack NY 10960-3204 146693
Petranker Stephan 170664-7 W 9/22/1995
CAN
Airmont NY 10952-4103 170664
Pierre Louisdon 239391-6 W 2/1/1999
CP
Suffern NY 10901-1802 239391
Pillitteri John 171267-8 W 11/18/1992
CAN
New City NY 10956-1622 171267
Pimentel Mariano Cezar Jr 166280-8 W 4/10/1997
CAN
West Nyack NY 10994-1236 166280
Polifrone Annarose 174514-0 W 10/20/1988
PMR
Pearl River NY 10965-2537 174514
Popowitz Richard Loria 231819-4 B 12/3/2004 12/22/2006 COS
Nanuet NY 10954-5288 231819
Pozner Joshua Harris 246036-8 B 10/24/2011 10/24/2011 CAN
Suffern NY 10901-5620 246036
Pritzker Henry Arthur 092039-7 W 10/5/1981
CR-DRA
New City NY 10956-1935 092039
Pucci Edward Anthony 231342-7 B 10/1/2007 6/6/2007 OPCS
Suffern NY 10901-5103 231342
Quijano Haidee Pidor 164459-0 W 7/2/1994
PN-P
Nanuet NY 10954-3093 164459
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 23 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
SPECIALTY
Rader Michael E 128034-6 W 10/23/1986
CIM-HEM
Nyack NY 10960-1912 128034
Raice Deborah Lee 165731-1 W 10/11/1988
CIM
Pomona NY 10970-3516 165731
Rainford Norbert W 122512-7 W 1/25/1984
CIM
New City NY 10956-7159 122512
CIM-CD
Rakhlin Aleksandr 241132-0 B 11/17/2011 11/17/2011 CS
West Nyack NY 10994-2229 241132
Rand Joseph J 094844-8 W 8/25/1969
CIM
New City NY 10956-3327 094844
CIM-END
Rao Geetha P 145525-2 W 11/8/1984
IM
Orangeburg NY 10962-1018 145525
Rastogi Shiv N 126652-7 W 6/22/1989
GP
Spring Valley NY 10977-1502 126652
Ravichandran Lalitha 182905-0 W 7/26/1994
CIM
Pomona NY 10970-3516 182905
Redler Lance David 101088-3 W 1/27/1972
CO
Suffern NY 10901-5103 101088
Reichard Steven Gerard 203668-9 W 6/8/1998
OPCR-DRA
Suffern NY 10901-4869 203668
Reis Norman Ira 091912-6 B 6/15/1965 4/2/2001 COS
Nanuet NY 10954-3623 091912
Renzoni Steven Alex 212885-8 W 4/5/2007
COS
Airmont NY 10952-3420 212885
Resnick Michael Ira 086369-6 W 3/22/1968
COS
Suffern NY 10901-7424 086369
Rhee Edward 209224-5 B 2/11/2002 2/11/2002 COL
West Nyack NY 10994-2229 209224
Riber Joshua Isaac 204143-2 B 1/30/2006 1/30/2006 CO
Monsey NY 10952-2829 204143
Rigor Virgilio U 165348-4 W 9/13/1995
CS
Valley Cottage NY 10989-2113 165348
Rivera Ramon E 232695-7 W 10/17/2005
S
New City NY 10956-5302 232695
Robinson Michael David 202294-5 W 9/21/1999
CPMR
Airmont NY 10952-3420 202294
Rosas Donovan Thomas Edgar 262423-7 W 10/3/2011
PS
Nyack NY 10960-1627 262423
Rosen Isidor Jack 081553-0 W 6/20/1975
CFP
West Nyack NY 10994-1802 081553
Rosenblatt Marc 148797-4 W 3/4/1994
OPCPMR
Suffern NY 10901-3223 148797
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 24 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Rosenthal Andrew M 130783-4 W 3/15/1982
CR
Pomona NY 10970-3519 130783
Rosenthal Stuart Alan 090757-6 B 9/25/1968 5/1/2001 CO
Garnerville NY 10923-1595 090757
Ross Cyril A 087003-0 W 5/25/1973
IM
Valley Cottage NY 10989-1619 087003
Ross Lawrence S 118150-2 W 10/7/1977
CIM
Monsey NY 10952-2433 118150
SPECIALTY
Roth Richard Lawrence 141477-0 W 9/5/1980
CIM
Suffern NY 10901-5208 141477
CIM-CD
Rowin Kenneth S 137171-5 B 11/30/2006 11/30/2006 CIM
West Nyack NY 10994-2233 137171
CIM-ID
Rubin Cheryl J 160306-7 W 12/16/1993
COS
Airmont NY 10952-3420 160306
Rubin Leo 098329-6 W 8/14/1968
GP
Suffern NY 10901-6511 098329
Rudin Leonard James 100580-0 W 12/27/1976
CU
New City NY 10956-2314 100580
Sadowski John Stanley 082638-8 B 12/20/1966 4/2/2001 COL
West Nyack NY 10994-2229 082638
Saffer Gerald N 122910-3 W 1/27/1980
CO
West Nyack NY 10994-2631 122910
Salerno Joseph A 120428-8 W 11/26/1976
CIM
New City NY 10956-3701 120428
Sandhu Nihal Singh 151247-4 W 7/6/1995
CIM
Nanuet NY 10954-2454 151247
CIM-PD
Sane Paul 102467-8 W 10/21/1980
CR
Orangeburg NY 10962-2318 102467
Sapoznikow Isaac 152180-6 W 10/16/1984
IM
West Nyack NY 10994-1834 152180
Sawhney Suman Kumar 146071-6 W 9/20/1990
CIM
Stony Point NY 10980-2400 146071
Sayegh Nabil J 140136-3 W 6/10/1986
CU
New City NY 10956-4021 140136
Scharff Paul William 083521-9 W
IM
Spring Valley NY 10977-6111 083521
Schneider Joseph Frank 100893-7 I 8/26/2003 CPN-CHN
Suffern NY 10901-3727 100893
Schwartz A David 045167-4 W 10/25/1960
CS
West Nyack NY 10994-2905 045167
Schwartz Joel Michael 167387-0 W 9/3/1996
CR-DRA
Nyack NY 10960-1912 167387
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 25 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
SPECIALTY
Schwartz Jonathan Berk 221056-5 W 2/1/2005
CR-DRA
West Nyack NY 10994-1608 221056
Schwartz Michael Lawrence 181505-9 I 7/22/2011 CS-GVS
Pomona NY 10970-3516 181505
S
Seliger Glenn Matthew 158696-5 B 2/2/1994 4/2/2001 CPN-N
West Haverstraw NY 10993- 158696
Selikowitz Michael M 140145-4 W 1/30/1989
CEM
Nanuet NY 10954-1044 140145
Semble Richard David 147885-8 B 12/14/1987 4/2/2001 COS
Orangeburg NY 10962-2186 147885
Shah Anita 215635-4 W 3/17/2003
IM
West Nyack NY 10994-2220 215635
Shah Parag Jitendra 215987-9 W 10/4/2002
CIM
West Nyack NY 10994-2228 215987
Shah Vikram Prataprai 170575-5 W 9/22/1988
CIM
Spring Valley NY 10977-5539 170575
Shahid Muhammad Amir 199429-2 W 8/7/2000
CIM
West Haverstraw NY 10993-1031 199429
Shaiman Robert S 173308-8 W 8/17/1992
IM
New City NY 10956-8578 173308
Shapiro Deborah Ann 183303-7 W 10/4/2002
CIM
West Nyack NY 10994-2220 183303
CIM-PD
Shapiro Kenneth S 127358-0 W 4/30/1982
CIM
West Nyack NY 10994-2220 127358
Shapiro Leonard Zelig 101096-6 B 9/25/1968 4/17/2001 CO
Pomona NY 10970-3516 101096
Sharma Devendra Mohan 110559-2 W 7/3/1987
CEM
Garnerville NY 10923-1718 110559
Sharma Mickey Pradeep 217358-1 I 5/14/2003 CIM
Garnerville NY 10923-1718 217358
Sheikh Fayyaz A 132458-1 W 7/21/1978
IM
Nanuet NY 10954-3328 132458
Shen Zhanqing 224050-5 W 5/17/2002
AN
Suffern NY 10901-4707 224050
Shreedhar Rakesh 169924-8 W 1/15/1992
CS
Stony Point NY 10980-2400 169924
Shuren Neal Howard 187591-3 W 11/1/1996
OS
Airmont NY 10952-3420 187591
Siegel-Goldman Shari 191088-4 W 8/25/1998
CR
New City NY 10956-5210 191088
Silberman Valeria 201324-1 W 3/17/1999
CIM
Suffern NY 10901-5010 201324
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 26 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Silver William S 125290-7 W 4/17/1979
IM
West Nyack NY 10994-1966 125290
Silverberg Nathaniel Hart 147186-1 W 12/17/1992
IM
Orangeburg NY 10962-2006 147186
Simon Jordan Adam 202036-0 W 4/2/2001
COS
Orangeburg NY 10962-2185 202036
Simon Lawrence Fredric 096815-6 B 7/26/1978 4/2/2001 CS
West Nyack NY 10994-2229 096815
Simons David Benjamin 135025-5 W 2/26/1992
CFP
Monsey NY 10952-1901 135025
Sivakumaran Chandrasekara 129685-4 W 11/14/1983
CAN
Blauvelt NY 10913-1002 129685
SPECIALTY
Slaten Warren K 235899-2 W 8/30/2005
CPMR
Airmont NY 10952-3420 235899
CPMR-PM
Sofair E Ezra 146267-0 W 11/19/1993
CAN
Spring Valley NY 10977-1707 146267
Southren David B 163321-3 W 3/2/1987
CIM
Valley Cottage NY 10989-2019 163321
Spinak Andrew 185039-5 B 11/3/1993 4/16/2001 CO
Pearl River NY 10965-2057 185039
Spinak Maria 121835-3 W 7/26/1978
CO
Pearl River NY 10965-2057 121835
Spitzer Daniel Evan 159515-6 B 3/30/1993 6/8/2001 CNS
Suffern NY 10901-5206 159515
Srinivasan Ramanatha 126695-6 W 1/3/1991
CEM
Nanuet NY 10954-1025 126695
Stangel Peter 104107-8 W 9/21/1983
CIM
Palisades NY 10964-0714 104107
CIM-PD
Steinfeld Leonard I 092679-0 W 10/1/1969
CIM
Monsey NY 10952-1633 092679
Stern Jud Marshal 192603-9 W 11/22/1995
IM
New City NY 10956-5703 192603
Stern Ronald A 157281-7 W 9/13/2002
IM
Pomona NY 10970-3020 157281
Sternberg Arthur 093429-9 W 8/9/1978
CPN-P
Suffern NY 10901-4143 093429
Stone Nelson Neal 158166-9 W 4/19/1993
CU
Suffern NY 10901-1601 158166
Subhedar Dilip Vasudev 183858-0 W 2/19/1999
CAN
Suffern NY 10901-4927 183858
CAN-PM
Sudarsky Laura A 163644-8 W 11/14/1990
CS
Nyack NY 10960-1627 163644
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 27 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Sun Jong C 120931-1 W 9/17/1974
CAN
Garnerville NY 10923-1912 120931
Svensson Kenneth B 167688-1 W 1/24/1991
FP
Nyack NY 10960-2623 167688
SPECIALTY
Tarle Marc E 141348-3 I 8/23/2001 CPN-P
New City NY 10956-5240 141348
Tash Robert Ryan 160976-7 W 4/23/1990
CR
Nyack NY 10960-1618 160976
Tendler Yacov 135395-2 W 4/18/1988
CIM
Monsey NY 10952-2833 135395
Thistle Howard George 094327-4 W 2/2/1966
CPMR
New City NY 10956-2114 094327
Tibere Emile 100080-1 W 7/30/1975
GP
Orangeburg NY 10962-2725 100080
Trubiano Paolo B 183486-0 W 4/27/1998
CAN
Suffern NY 10901-5620 183486
Tucker David 103550-0 B 9/17/1974 4/20/2001 COS
Airmont NY 10901-6631 103550
Tuckman Alan Joel 092298-9 B 7/30/1996 4/2/2001 CPN-P
Pomona NY 10970- 092298
Umberger Daniel 228091-5 W 5/9/2006
OPGP
New City NY 10956-3318 228091
Valow-Picarello Lisa M 204365-1 W 2/9/1998
CFP
Pomona NY 10970-3530 204365
Vasishtha Deepak 231223-9 W 6/9/2004
PMR
Nanuet NY 10954- 231223
Veitch Sidney O 128797-8 W 3/11/2002
AN
New City NY 10956-1920 128797
Ventrudo Steven L 166157-8 W 10/21/1991
CFP
Tappan NY 10983-2514 166157
Vick Angela Kaye 202783-7 W 1/12/1998
CAN
Valley Cottage NY 10989-2205 202783
Waldorf Donald Scott 092756-6 W 10/9/1967
CD
Nanuet NY 10954-2312 092756
Waldorf Heidi Ann 195965-9 W 9/3/1996
CD
Nanuet NY 10954-2312 195965
Walters Denny W 119542-9 W 5/18/1994
CPN-P
Nanuet NY 10954-3008 119542
Weg Noah 101664-1 W 10/24/1973
CR
Monsey NY 10952-2448 101664
Weinstein Zelig Reuven 127373-9 W 1/26/1993
CR
Monsey NY 10952-2800 127373
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 28 of 29
PHONE NEW

COUNTY
NAME/ADDRESS
ROCKLAND
NEW YORK STATE WORKERS' COMPENSATION BOARD
AUTHORIZATION # / DATES
AUTHORIZED PROVIDERS - NAME ORDER REPORT
PHYSICIANS(INCLUDES OSTEOPATHS)
LICENSE # Treat IME
Weiss Glen Howard 192800-1 B 3/2/1998 5/1/2001 CO
Garnerville NY 10923-1595 192800
Weiss-Citrome Amy Michele 158865-6 B 6/18/1994 4/2/2001 CPMR
Suffern NY 10901-2307 158865
Weissman Harold H 124575-2 W 12/12/1979
CO
Suffern NY 10901-5152 124575
Weltin Johannes Desiderius 140837-6 W 6/7/1982
CFP
New Square NY 10977-8917 140837
Wistreich Peter M 150164-2 W 7/24/1990
CEM
Nyack NY 10960-4114 150164
CIM
SPECIALTY
Wu Jiajia 227298-7 B 6/12/2007 6/12/2007 CR-DRA
Stony Point NY 10980-3515 227298
Xiong Tiexin 208805-2 W 4/22/2003
AN
Suffern NY 10901-5620 208805
Yablon Steven B 130259-5 W 4/30/1982
CIM
New City NY 10956-4438 130259
Zachariah Mano Rajan 229871-9 W 11/3/2004
CIM
Orangeburg NY 10962-2320 229871
Zakiullah Mohammad 138060-9 W 2/9/1981
IM
West Nyack NY 10994-1424 138060
Zemel Anna Rynskaya 169180-7 B 7/8/1992 4/2/2001 CIM
New City NY 10956-1132 169180
Zheng Yining 224354-1 W 10/6/2003
CPMR
Airmont NY 10952-3420 224354
Zimmerman Leonard 106435-1 W 12/11/1974
CIM
West Nyack NY 10994-2220 106435
Zimmerman Marc S 134846-5 W 11/3/1986
CIM-ONCL
Pomona NY 10970-3568 134846
Zucker Albert Harry 167233-6 W 1/23/1989
CIM
Suffern NY 10901-3602 167233
Zwickler Don 165180-1 W 7/9/1996
CIM-END
Pomona NY 10970-3516 165180
* - Indicates that the provider is new this month
AUTHORIZATION # SUFFIX KEY: W - WCB Treat Only, I - IME Only, B - Both IME and WCB Treat
IME Authorized Providers Effective March 20, 2001
11/15/2012 Page 29 of 29
PHONE NEW