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Cover Page

State of New York Department of HealthDelivery System Reform Incentive Payment (DSRIP) Program

Project Design Grant Application

There will be no extensions for this application. Any application submitted past the due date will not be considered.

Section 1 Lead Applicant Info & Project Point of Contact Section 6 List of VendorsSection 2 Partner Organization - Contact Info Section 7 Design Grant TimelineSection 3 Partner Organizations & Service Area Section 8 Data RequestSection 4 Project Program Overview & Description Section 9 Design Grant BudgetSection 5 Community Needs Assessment & Stakeholder Engagement Section 10 Project Advisory Committee (PAC)

Special Terms & Conditions Attachment I Attachment J

(Recommend) - PowerPoint/Webinar

DSRIP LINK:

Application Due on: June 17, 2014

To understand the Project Design Grant Application, carefully and thoroughly read through the Instructions before completing this application.

As a reminder and an addition to the instructions, you MUST read through the following state documents which are provided on the DSRIP website (see link below).

https://www.health.ny.gov/health_care/medicaid/redesign/delivery_system_reform_incentive_payment_program.htm

https://www.health.ny.gov/health_care/medicaid/redesign/delivery_system_reform_incentive_payment_program.htm


NYS DOH DSRIP_Project Design Grant Application Section 1 Applicant Info_Project Contact_Partner Organizations

Project Point of ContactLead Applicant Information Primary Contact

Contact Person: Frank Campbell1.1) Organization Name: SUNY Downstate Medical Center Address City State Zip Code

Operating Certificate # (Opcert): 7001037H Organization Address: 450 Clarkson Avenue Brooklyn NY 11203Provider Type: Public Hospital Contact Phone Number: (617) 834-9204 Extension:

Provider Type - OTHER: 7001037H Contact Email: [email protected]: 2998694 1.4)

Billing Entity ID: Secondary ContactNPI #1: 1639179328 Contact Person: Grace WongNPI #2: Address City State Zip Code

Federal Employer ID (FEIN): Organization Address: 450 Clarkson Avenue Brooklyn NY 11203Contact Phone Number: (718) 826-5029 Extension:

Contact Email: [email protected]

1.2) Please provide a brief statement as to why the lead organization is qualified to serve in this capacity. ( Restricted to 3000 characters)

Characters used: 1896

1.3)

OR

#1 Is the lead applicant one of the following providers? State University of New York Medical Centers %

OR Select One

%A. 2A

Select One

B. 2B

OR

#3 Select One 3

For Safety-net definition, please see link:

SUNY Downstate Medical Center is uniquely qualified to be the lead organization of the Performing Provider System. As the leading educator of Brooklyn’s health care professionals, SUNY Downstate has the stature and relationships necessary for leadership, as well as an educational platform to support workforce retraining. Academically, its training programs will serve as a foundation for developing and leading workforce retraining, a crucial enabler of transformational change to community-based care. From a clinical perspective, SUNY Downstate has pioneered a number of community based collaborations that extend beyond its campus aimed at reducing avoidable hospitalizations. A recent example that provides evidence of the institution’s leadership is the Brooklyn Healthcare Improvement Project (B-HIP), which conducted a landmark health needs study from 2009 through 2012, a project supported with New York State HEAL grant funding.

The B-HIP project involved collaboration with numerous healthcare providers, community-based organizations, hospitals, insurers, health homes, mental health providers, developmental disability groups, substance abuse providers, government agencies, industry, and other groups concerned about health outcomes in the medically underserved neighborhoods of Northern and Central Brooklyn. While the DSRIP program is significantly larger and more transformational than B-HIP, the informal collaborative borne out of B-HIP will provide a foundation for engaging community stakeholders. Since issuance of the B-HIP study and recommendations in 2012, the member organizations have continued to assist the coalition in seeking funding for transformative projects in Northern and Central Brooklyn. With the DSRIP opportunity, the B-HIP organizations and SUNY are primed to take the lead in transforming how healthcare is delivered and utilized in Brooklyn.

Based on the lead applicant provider type, please fill out the applicable section below to verify that you meet the DSRIP safety- net definition (Either Hospital OR Non-hospital based) :

Hospital: A hospital must meet one of the three following criteria to participate in a performing provider system: Non-Hospital Based Provider - Must meet the following criteria:

Not participating as part of a state-designated Health Home, must have at least 35 percent of all patient volume in their primary lines of business and must be associated with Medicaid, uninsured and Dual Eligible individuals. (Please indicate what %)

#2 - Must pass both A & B test (Please indicate what % for both tests)

At least 35 percent of patient volume in their outpatient lines of business must be associated with Medicaid, uninsured, and Dual Eligible individualsAt least 30 percent of inpatient treatment associated with Medicaid, uninsured, and Dual Eligible individuals

Must serve at least 30 percent of all Medicaid, uninsured and Dual Eligible members in the proposed county or multi-county community. (The state will use Medicaid claims and encounter data as well as other sources to verify this claim. The state reserves the right to increase this percentage on a case by case basis so as to ensure that the needs of each community's Medicaid members are met.(Please indicate what %)

https://www.health.ny.gov/health_care/medicaid/redesign/docs/safety_net_definitions.pdf

https://www.health.ny.gov/health_care/medicaid/redesign/docs/safety_net_definitions.pdf


NYS DOH DSRIP_Project Design Grant Application Section 2 Partner Organizations' - Contact Info

2.1) Partner Organizations - Contact Information

1 Organization Name: 2 Organization Name:Qualified Under Safety Net Definition? Select One (Please select Yes or No) Qualified Under Safety Net Definition? Select One (Please select Yes or No)

Address City State Zip Code Address City State Zip Code

Organization Address: Organization Address:Contact Person: Contact Person:

Contact Phone Number: Extension: Contact Phone Number: Extension:Contact Email: Contact Email:Provider Type: Select One Provider Type: Select One

Provider Type - OTHER: MMIS: Provider Type - OTHER: MMIS:Operating Certificate Number (OPCERT): Billing/Provider Entity ID: Operating Certificate Number (OPCERT): Billing/Provider Entity ID:

NPI #1: NPI #1: NPI #2: NPI #2:

Federal Employer ID (FEIN): Federal Employer ID (FEIN):


Address City State Zip Code Address City State Zip CodeOrganization Address: Organization Address:

Contact Person: Contact Person:Contact Phone Number: Extension: Contact Phone Number: Extension:

Contact Email: Contact Email:Provider Type: Select One Provider Type: Select One


NPI #1: NPI #1: NPI #2: NPI #2:







NPI #1: NPI #1: NPI #2: NPI #2:







NPI #1: NPI #1: NPI #2: NPI #2:







NPI #1: NPI #1: NPI #2: NPI #2:








NPI #1: NPI #1: NPI #2: NPI #2:







NPI #1: NPI #1: NPI #2: NPI #2:







NPI #1: NPI #1: NPI #2: NPI #2:







NPI #1: NPI #1: NPI #2: NPI #2:







NPI #1: NPI #1: NPI #2: NPI #2:



NYS DOH DSRIP_Project Design Grant Application Section 3 Partner Organizations Service Area

Partner Organizations

3.1)Yes

Provide explanation (Restricted to 2000 characters):


Service Area3.2) Briefly describe the proposed service area for your entire emerging Performing Provider System below. (e.g. general overview, geographic location, any notable characteristics specific to your population, etc.) ( Restricted to 3000 characters)

Do any regulations need to be waived to accomplish a DSRIP partnership within your emerging Performing Provider System?

Please consider the following regulatory waivers to enable effective cooperation and management of services and resources across the PPS:

Various construction related regulationsCON regulations and other regulations that oversee approval of clinical programs along the continuum of care Any state mandated education regulations pertaining to health care (e.g., demographic make-up of class size, etc.), especially related to workforce retrainingMedical licensure regulations to allow clinicians to practice across organizational boundariesState of NY anti-trust regulations. Consider providing Certificate of Public AdvantageState of NY regulations related to inter-provider referralsRegulations related to workforce redesignSharing of patient data across the continuum of care under a single consent model, so patients need to provide only one universal consent throughout the PPS. Waiver of Scope of Practice regulations that hinder providers’ ability to practice at the top of their license. Enable home health aides to administer medication. Remove the requirement of physicians to supervise appropriately credentialed home health providers such as RNs and NPs. Allow NP/PAs to sign home care orders and document the required face-to-face encounterAllow various waivers afforded to MSSP ACOsCorporate practice of medicine regulationsCo-location restrictions for services that integrate behavioral and physical health care and private physician practice.Allowances for widespread use of nurse-driven protocols, consistent with federal/national standardsImpediments to rapidly transition patients between care levels need to be waivedFlexibility, consistent with statute, with respect to use of observation servicesNursing home regulations need to be modified to allow for appropriate therapeutic interventions within the nursing homeAdditional regulatory waivers will likely need to be provided throughout the duration of the waiver.

The PPS service area covers the entire borough of Brooklyn (Kings County) through its provider network. More than half of Brooklyn’s 2.6 million residents are on Medicaid, representing the highest concentration of Medicaid members and poorest service areas in the state. Its diverse population from across the globe presents a unique variety of health care and social needs, exacerbated by language barriers related to more than 35 spoken languages in the service area and health care disparities among minorities. As a reflection of its widespread poverty, the borough is challenged with a lack of resources and alternatives to inappropriate use of the ER.

Chronic disease prevalence in Brooklyn is among the highest in the state. According to analysis of Medicaid claims data provided by GNYHA, the total chronic disease burden (total number of Medicaid members with condition) for most chronic conditions is the highest among the five boroughs in New York City and often is the highest in the State. High rates of potentially preventable ED use and avoidable hospital admissions are also prevalent.

Key indicators are included below.

Behavioral Health - Depression Prevalence, 4.09% (n=50,644; highest in NYS) - Schizophrenia, 2.35% (n=29,041; highest in NYS)Cardiovascular Conditions - Hypertension Prevalence, 15.37% (n=190,220; highest in NYS) - Chronic Health Failure, 2.04% (n=25,192; highest in NYS)Diabetes: 7.72% (n=95,562; highest in NYS)Asthma: 6.03% (n=74,622; highest in NYS)HIV: 1.32% (n=16,365; highest in NYS)Prematurity: <1000g Birthweight, .04% (n=554; highest in NYS)

The GNYHA data presented above are corroborated by the B-HIP study, which identified the location of three geographic “hotspots” with the most problematic healthcare status and utilization in all of Brooklyn with the highest rates of preventable visits to local EDs: 1) Brownsville/East New York, 2) Crown Heights North/Bedford Stuyvesant, and 3) Bushwick/Stuyvesant Heights. The B-HIP study identified these hot spots, defined as groups of densely populated census tracts where incidence of chronic diseases and annual rates of ACSC hospital discharges and ED utilization are highest. Together, the three hot spots represent 9% of all potentially preventable ER visits, 6% of all discharges, and 8% of all ACSC discharges in Brooklyn, but only 4% of the borough’s population.

Lack of access and provider shortages represent a significant barrier to addressing the service area’s health care needs. In Brooklyn, there are and 391 Medically Underserved Areas (MUAs) and 745 Health Professional Shortage Areas (HPSAs) as designated by HRSA, including 362 for primary care services, 184 for dental services, and 199 for mental health services (many of which are co-located).




The PPS service area covers the entire borough of Brooklyn (Kings County) through its provider network. More than half of Brooklyn’s 2.6 million residents are on Medicaid, representing the highest concentration of Medicaid members and poorest service areas in the state. Its diverse population from across the globe presents a unique variety of health care and social needs, exacerbated by language barriers related to more than 35 spoken languages in the service area and health care disparities among minorities. As a reflection of its widespread poverty, the borough is challenged with a lack of resources and alternatives to inappropriate use of the ER.

Chronic disease prevalence in Brooklyn is among the highest in the state. According to analysis of Medicaid claims data provided by GNYHA, the total chronic disease burden (total number of Medicaid members with condition) for most chronic conditions is the highest among the five boroughs in New York City and often is the highest in the State. High rates of potentially preventable ED use and avoidable hospital admissions are also prevalent.

Key indicators are included below.

Behavioral Health - Depression Prevalence, 4.09% (n=50,644; highest in NYS) - Schizophrenia, 2.35% (n=29,041; highest in NYS)Cardiovascular Conditions - Hypertension Prevalence, 15.37% (n=190,220; highest in NYS) - Chronic Health Failure, 2.04% (n=25,192; highest in NYS)Diabetes: 7.72% (n=95,562; highest in NYS)Asthma: 6.03% (n=74,622; highest in NYS)HIV: 1.32% (n=16,365; highest in NYS)Prematurity: <1000g Birthweight, .04% (n=554; highest in NYS)

The GNYHA data presented above are corroborated by the B-HIP study, which identified the location of three geographic “hotspots” with the most problematic healthcare status and utilization in all of Brooklyn with the highest rates of preventable visits to local EDs: 1) Brownsville/East New York, 2) Crown Heights North/Bedford Stuyvesant, and 3) Bushwick/Stuyvesant Heights. The B-HIP study identified these hot spots, defined as groups of densely populated census tracts where incidence of chronic diseases and annual rates of ACSC hospital discharges and ED utilization are highest. Together, the three hot spots represent 9% of all potentially preventable ER visits, 6% of all discharges, and 8% of all ACSC discharges in Brooklyn, but only 4% of the borough’s population.

Lack of access and provider shortages represent a significant barrier to addressing the service area’s health care needs. In Brooklyn, there are and 391 Medically Underserved Areas (MUAs) and 745 Health Professional Shortage Areas (HPSAs) as designated by HRSA, including 362 for primary care services, 184 for dental services, and 199 for mental health services (many of which are co-located).



3.3) Check off with a "X" of all the counties that are within your emerging Performing Provider System proposed service area.

Albany Herkimer Richmond (Staten Island)Allegany Jefferson RocklandBronx X Kings (Brooklyn) Saint LawrenceBroome Lewis SaratogaCattaraugus Livingston SchenectadyCayuga Madison SchoharieChautauqua Monroe SchuylerChemung Montgomery SenecaChenango Nassau SteubenClinton New York (Manhattan) SuffolkColumbia Niagara SullivanCortland Oneida TiogaDelaware Onondaga TompkinsDutchess Ontario UlsterErie Orange WarrenEssex Orleans WashingtonFranklin Oswego WayneFulton Otsego WestchesterGenesee Putnam WyomingGreene Queens YatesHamilton Rensselaer

Please type in the letter "X" OR you can use the drop down menu:


NYS DOH DSRIP_Project Design Grant Application Section 4 Project Program Overview/Description

Project Program Overview

DSRIP Projects - Must choose a Minimum of 5, Maximum of 10:

Domain 2 - Must select 2 projects, Maximum of 4 - At least 1 from sub list A, and 1 from sub list B or C.Domain 3 - Must select 2 projects, Maximum of 4 - At least 1 from sub list A, and 1 from sub list A, B, C, D, E, F, G or H.Domain 4 - Must select 1 project, Maximum of 2 - At least 1 from sub list A, B, C or D.** Please see Appendix B in the Instructions for details of each Domain. For further information, see link below for the DSRIP Project Toolkit**

DSRIP Project Toolkit:

4.1)

Project #1- Sub-list A I.S.

2.A.I Create Integrated Delivery Systems that are focused on Evidence Based Medicine / Population Health Management 56

Project #2- Sub-list B or C I.S.

2.B.IV Care transitions intervention model to reduce 30 day readmissions for chronic health conditions 43

Project #3 I.S.

2.A.IV Create a medical village using existing hospital infrastructure 54

Project #4 I.S.

2.B.VIII Hospital-Home Care Collaboration Solutions 45

Provide reasoning regarding why your emerging Performing Provider System has selected the projects listed above from Domain 2 (Restricted to 4000 characters)


4.2)

Project #1- Sub-list AI.S.

3.A.I Integration of primary care services and behavioral health 39

Project #2- Sub-list A - HI.S.

3.B.I Evidence based strategies for disease management in high risk/affected populations (adult only) 30

https://www.health.ny.gov/health_care/medicaid/redesign/docs/dsrip_project_toolkit.pdf

Domain 2 (System Transformation) - Applicants must select a minimum of two projects, maximum of 4 from this domain (one of which must be from sub-list A and one of which must be from sub-list B or C)

(REQUIRED) Must choose 1 from sub list A-->

(REQUIRED) Must choose 1 from sub list B or C-->

(NOT REQUIRED) Can choose 1 from sub list A, B or C-->

(NOT REQUIRED) Can choose 1 from sub list A, B or C-->

This PPS selected four projects in Domain 2. The market is currently served by a highly fragmented collection of providers who are joining together in this PPS to offer the market a more cohesive, integrated delivery model than currently exists in Brooklyn.

Project 2.A.i (creation of an integrated delivery system (IDS) focused on evidence-based care and population management) will focus on integrating at least four acute care hospitals (SUNY Downstate, Brookdale Medical Center, Interfaith Medical Center and Kingsbrook Jewish Medical Center) into an organization with common governance and shared financial risk. The affiliation will catalyze service integration across the four sites in terms of clinical programs, physician leadership and medical staff organization, capital investment, etc., and will optimally distribute services in the borough. This project will create strong, integrated governance within the IDS, and will simplify and streamline governance among participating providers within the PPS. The formation of this affiliated structure will establish durability of the proposed care model redesign across all projects. It will also remove costs that can be invested in prevention and care coordination to reduce unnecessary admissions and ED visits. Project 2.A.4 (creation of a medical village using existing acute care infrastructure) will re-purpose excess acute care capacity into a needed ambulatory site devoted to population health and the care of chronically ill patients. The medical village will include a redesigned care model that coordinates care and provides navigation services to patients with complicated treatment regimens. Re-purposing assets in this way will provide Brooklyn residents with access to facilities and programs that do not exist today, in a delivery model that will simplify and coordinate the various services they need. The medical village will support the disease programs selected in Domain 3, and will also help to improve quality of care for chronically ill patients while lowering unnecessary admissions and ED visits.

Project 2.B.4 (care transitions intervention model to reduce 30-day readmissions for chronically ill patients) and Project 2.B.8 (hospital-home care collaboration) will also focus on creating coordination of care along the care continuum, which addresses a significant need in Brooklyn’s fragmented health care market. These programs will extend the care coordination from the medical village to “between appointment” care in patients’ homes or community-based sites. By engaging the patients before or just after acute care episodes, these projects will take the care delivery model to the patients and prevent acute care episodes before they happen. By engaging patients in more convenient settings than the ED, the projects will also support a change in patient behavior and preference towards receiving care in more cost effective care settings.

Domain 3 ( Clinical Improvement) – Applicants must select at least two projects from this domain (one of which must be A. Behavioral Health), but can submit up to 4 projects from Domain 3 for scoring purposes

(REQUIRED) Must choose 1 from sub list A-->

(REQUIRED) Must choose 1 from sub list A, B, C, D, E, F, G or H-->

https://www.health.ny.gov/health_care/medicaid/redesign/docs/dsrip_project_toolkit.pdf



Project #3- Sub-list A - H I.S.

3.CI Evidence-based strategies for disease management in high risk/affected populations (adults only) 30

Project #4- Sub-list A - H I.S.

3E.I 28



4.3)

Project #1- Sub-list A-D I.S.

4.B.I Promote tobacco use cessation, especially among low SES populations and those with poor mental health 23

Project #2- Sub-list A-D I.S.

4.CII Increase early access to, and retention in, HIV care 19


(NOT REQUIRED) Can choose 1 from sub list A, B, C, D, E, F, G or

H-->

(NOT REQUIRED) Can choose 1 from sub list A, B, C, D, E, F, G or

H-->Comprehensive Strategy to decrease HIV/AIDS transmission to reduce avoidable hospitalizations – development of a

Center of Excellence for management of HIV/AIDS

While the PPS will conduct an updated Community Health Needs Assessment during the design phase, the projects in this domain were chosen based on existing Community Health Needs Assessments, inpatient and outpatient statistics, and the Brooklyn Healthcare Improvement Project (BHIP) analysis completed in 2012. The projects were arrayed against relevant criteria – community need, provider capability to succeed and meet metrics, DOH scoring of projects, and a project’s projected impact on reducing unnecessary admissions and ER visits. Project selection was made objectively based on these criteria.

More specifically, Brooklyn has a high incidence rate of behavioral health, cardiovascular disease (including CHF), and diabetes, with a high co-morbidity rate linking behavioral health conditions with the other disease categories selected. By linking behavioral health with medical care, this will enable redesigned care teams focusing on the chronically ill to care for the mind and body holistically. It will also provide care teams with a more complete understanding of the patient in terms of patient attitudes and compliance, and mental health issues complicating healthy lifestyle habits such as diet, exercise, keeping medical appointments, drug regimen adherence, etc. By integrating behavioral health and medical care, the transformed delivery model will have a better chance of “breaking the cycle” of recurring admissions and ER visits.

As noted, in the Brooklyn market, according to the BHIP research, there are selected geographic “hot spots” that pinpoint high incidence rates for chronic heart failure and diabetes. The selected Domain 3 projects will specifically target these high risk neighborhoods and include strategies for bringing the care model out of acute care settings into more accessible settings, such as the medical village or community based locations. The projects selected in Domains 2 and 3 have synergistic value to drive improvement in outcomes and efficacy, as well as the overall success of the PPS’s DSRIP programs.

HIV was selected as a Domain 3 project because of the need to coordinate complex care among many providers across the continuum. HIV infection rates continue to remain high in Brooklyn. A coordinated effort unifying the several HIV-focused organizations in the service area will establish care models that treat HIV patients in community-based settings and reduce avoidable ER visits.

Domain 4 (Population-wide Strategy Implementation) – Applicants must select at least one project from this domain, but can submit up to 2 projects from Domain 4 for scoring purposes.

(REQUIRED) Must choose 1 from sub list A, B, C, or D-->

(NOT REQUIRED) Can choose 1 from sub list A, B, C, or D-->

Two criteria drove the selection of Domain 4 projects. The projects had to relate to and support projects selected in Domains 2 and 3. Because Domain 2 and 3 projects were based on current knowledge of community need, Domain 4 projects are similarly responsive to community need while providing synergistic advantages with the One Brooklyn Health PPS’s broader DSRIP program.

The second criteria involved selecting common projects with other PPS consortia across Brooklyn and New York City. At DOH urging, selection of the same Domain 4 projects across the borough and/or the city would increase the cost effectiveness and efficacy of the programs. This coordinated approach would unify support from the mayor and borough offices, create stronger appeal among media outlets to support 1 or 2 projects instead of receiving requests to support several, and create economies of scale for developing educational and related material.

Smoking cessation is cited in many studies as a program of top importance in New York City and Brooklyn. The incidence rate of smoking is driven by poverty and the influx of immigrants from countries with significantly higher rates of smokers than the United States. Also, smoking cessation will support the clinical programs selected in Domain 3 as cardiovascular disease and diabetes have known health linkages to smoking.

The selection of the HIV program reinforces the clinical program selected in Domain 3. HIV (and STD) prevention on a city wide basis will also benefit from economies of scale in terms of media play (which crosses borough boundaries) and program development activities. It will also help link and leverage the expertise of small CBOs across the city that are focused on HIV care and prevention.



Project Description

4.4)


4.5)


4.6)

Provide a brief executive summary of your emerging Performing Provider System's vision and goals and how your emerging Performing Provider System hopes to sustain these achievements beyond the DSRIP program timeframe. (Restricted to 3000 characters)

The overarching vision of the PPS is to organize key health care institutions into an integrated delivery system (IDS) with common leadership and shared financial risk. Under centralized control, the PPS will be able to make rational, deliberate decisions to reduce redundant investment in clinical programs. This will allow the IDS to create stronger, centralized clinical programs in the acute care setting at lower than historical costs, while reinvesting savings in community-based models of care. This vision will lead to the attainment of several important goals: improved care at lower cost, financial stability among IDS legacy organizations, and rationalized investment in clinical programs across participating providers. Our emerging PPS will be focused on achieving the triple aim (improving the patient experience of care, improving the health of populations, and reducing the per capita cost of healthcare). It will also enable us to enter into shared savings arrangements with our insurance partners to ensure sustainability.

Currently, IDS legacy organizations maintain common clinical programs which require investment in capital, physician recruitment, and program support costs. Under an IDS structure with central leadership and shared financial risk, it will be possible to work collaboratively to reduce redundant investment in expensive medical equipment while recruiting high caliber clinical leadership to oversee IDS clinical programs.

The participating provider organizations represent virtually all segments of the care continuum. This will accumulate expertise and resources under one umbrella to optimize the use of more effective, lower cost settings to prevent unnecessary admissions and ER visits. Also, the inclusion of SUNY Downstate will leverage significant medical education assets to address workforce retraining, which represents a critical enabler to transforming the care delivery platform that exists in Brooklyn today. The elements of the proposal have been carefully chosen with a central goal in mind: to provide a fiscally sustainable, population health-oriented solution to the current crisis.

Within Brooklyn, the chosen target population, geographic area and providers that serve them are in the greatest need of transformation. The potential for value improvement is enormous, and the organizations whose business model will have to be transformed most deeply – the hospitals – are core partners of the proposal.

In summary, the PPS success factors rest on strengthened central governance, financial interdependency, and shifting assets among acute care providers and from acute care providers to ambulatory and post-acute settings. Together, these structural improvements will support a more responsive, flexible care network and care delivery model.

Why does your emerging Performing Provider System, as a whole, feel uniquely qualified to participate in DSRIP and serve the area you have proposed? (Restricted to 3000 characters)

This emerging performing provider system, is uniquely qualified to participate in DSRIP and serve its primary service area of Northern and Central Brooklyn. SUNY Downstate Medical Center, as its lead organization, has the unique ability to unite the providers within its primary service area by virtue of their common academic training and research. Downstate has trained a preponderance of providers within the market. The PPS, through its member organizations, is intimately acquainted with the market and populations it serves. The member organization represent virtually all points on the care continuum and have a history of working collaboratively, either within B-HIP or through educational programs that connect the missions of the various institutions. Their collective missions and knowledge of the Brooklyn service area and population position the PPS to drive transformational change under DSRIP.

The leadership and financial integration of at least four acute care facilities in the PPS will create a framework and platform for strong governance within the PPS. We have assembled all of the major home and community based providers (including CHHAs, hospices, nursing Homes, LHCSAs,) a wide array of housing, health home, mental health, AIDS, community organizations, substance abuse and developmental disability serve providers. We have working relationships with all of the major providers of care coordination, including the health homes. We have working relationships with the major Medicaid managed care companies and with Healthix.

Additionally, SUNY’s educational programs provide a platform for designing and executing educational programs required to retrain members of the acute care workforce for care coordination and/or community-based health care roles. SUNY’s educational programs will also serve as a change catalyst for supporting the transition from fee for service to a population health mindset and care delivery model.

Development of the retraining programs will also catalyze curricula redesign towards population health perspectives in its traditional degree programs. Training tomorrow’s leaders on the new model of care will support sustainability and advancement of the reforms.

What specific challenges does your emerging Performing Provider System foresee that could hinder the implementation of its DSRIP Project Plan? (Restricted to 3000 characters)

At least four challenges may emerge during the implementation of the DSRIP Project Plan. The first challenge is creating strong integration across a diverse range of providers, each with a unique niche along the continuum of care, different organizational cultures, and different budgets and funding sources. These organizations vary in terms of size, scope, and mission. The transition into working collaboratively may prove to be difficult during implementation. Establishing clear lines of leadership in clinical programs and administrative areas, supported by aligned incentives in the funds flow design, will mitigate this risk.

Next, the PPS member hospitals and other providers currently do not utilize the same, or easily interoperable, medical information systems. They may not be active users of Healthix, the health information exchange for New York City. It is neither economical nor feasible to acquire and implement a single electronic medical system for all PPS partners within the 5 year DSRIP time frame. Therefore building the necessary infrastructure to connect to and utilize Healthix will be indispensable to achieving the level of care management across institutions that will be necessary to reduce unnecessary admissions and ER visits while improving quality of metrics.

The third challenge is educating patients on new models of care. Many patients are linguistically isolated with low levels of educational attainment and are underinsured or uninsured. These factors suggest the habitual inertia of Medicaid members will lead to the continued use of the ER and acute care unless targeted means of outreach to educate them are implemented. Determining how best to facilitate this outreach and to execute effectively will drive meaningful change and reduce this risk.

Managing cash flow for DSRIP projects across the PPS represents another top concern. Receipt of incentive payments will arrive after the conclusion of DSRIP fiscal years to allow DOH to calculate performance against metrics. While this approach will align performance and payment, it will require PPS participating providers to invest working capital during the course of the performance year with the hope of achieving reimbursement via incentive payments. Many Brooklyn providers may lack the financial resources to front working capital for DSRIP projects. This will need to be carefully analyzed during the Design Phase.




At least four challenges may emerge during the implementation of the DSRIP Project Plan. The first challenge is creating strong integration across a diverse range of providers, each with a unique niche along the continuum of care, different organizational cultures, and different budgets and funding sources. These organizations vary in terms of size, scope, and mission. The transition into working collaboratively may prove to be difficult during implementation. Establishing clear lines of leadership in clinical programs and administrative areas, supported by aligned incentives in the funds flow design, will mitigate this risk.

Next, the PPS member hospitals and other providers currently do not utilize the same, or easily interoperable, medical information systems. They may not be active users of Healthix, the health information exchange for New York City. It is neither economical nor feasible to acquire and implement a single electronic medical system for all PPS partners within the 5 year DSRIP time frame. Therefore building the necessary infrastructure to connect to and utilize Healthix will be indispensable to achieving the level of care management across institutions that will be necessary to reduce unnecessary admissions and ER visits while improving quality of metrics.

The third challenge is educating patients on new models of care. Many patients are linguistically isolated with low levels of educational attainment and are underinsured or uninsured. These factors suggest the habitual inertia of Medicaid members will lead to the continued use of the ER and acute care unless targeted means of outreach to educate them are implemented. Determining how best to facilitate this outreach and to execute effectively will drive meaningful change and reduce this risk.

Managing cash flow for DSRIP projects across the PPS represents another top concern. Receipt of incentive payments will arrive after the conclusion of DSRIP fiscal years to allow DOH to calculate performance against metrics. While this approach will align performance and payment, it will require PPS participating providers to invest working capital during the course of the performance year with the hope of achieving reimbursement via incentive payments. Many Brooklyn providers may lack the financial resources to front working capital for DSRIP projects. This will need to be carefully analyzed during the Design Phase.


NYS DOH DSRIP_Project Design Grant Application Section 5 Community Needs Assessment

Community Needs Assessment

Examples of items to include in the descriptions can be found in the instructions.

Description

5.1)

Planning and Organizing


Description - Each box is restricted to 5000 characters.

~ Keep in mind, the description box will expand as you type ~

One, borough-wide Community Needs Assessment for Brooklyn will be conducted by the New York Academy of Medicine

Seven of the Brooklyn emerging Performing Provider Systems (PPSs) – Lutheran, Maimonides, SUNY Downstate, A W Medical Office, and the NYCHHC Kings County, Woodhull and Coney Island-led PPSs -- will work together to create one, borough-wide Community Needs Assessment (CNA). This approach allows for the most thorough and appropriate view in assessing the current resources, needs and potential gaps in care for all Brooklyn residents. To direct and coordinate the CNA, the PPSs will partner with the New York Academy of Medicine (NYAM). NYAM is an independent, non-partisan, non-profit organization based in East Harlem that has been advancing urban population health since 1847. NYAM addresses health challenges facing the world’s urban populations through interdisciplinary approaches to policy leadership, innovative research, evaluation, education, and community engagement. For the Brooklyn CNA, NYAM leadership and staff from the Division of Health Policy, the Center for Evaluation and Applied Research, and the Center for Health Innovation will form an interdisciplinary team that brings years of expertise and experience in conducting Community Health Needs Assessments (CHNAs). The protocol for the CNA will be submitted to NYAM’s Institutional Review Board (IRB) to ensure the protection of community members participating in the needs assessment. Governance and Community Partnerships

Each PPS will appoint representatives to form a CNA Steering Committee, which will govern the CNA process. The steering committee will have biweekly calls or in-person meetings with NYAM to monitor and assure timely implementation of the CNA process. Each of the participating institutions also has strong partners in the community, including community based organizations (CBOs), local government officials, schools, faith institutions, and local service providers. Information about PPS planning and implementation will be communicated to these partners through in-person meetings and e-communications (e.g., web postings, email blasts). The CNA is conceived of as an interactive process that provides a feedback loop to continuously define areas of need, establish relationships with community partners, and hone efforts to address gaps in health care delivery for the Brooklyn community.

Community Needs Assessment Plan - NYAM will work with the seven Brooklyn-based PPSs to pool the rich and copious existing health data sources, including the CHNAs and related documents prepared by Brooklyn hospitals, reports prepared by the NYS Department of Health , NYC Departments of Health and City Planning and Brooklyn Healthcare Improvement Project, publicly available survey data (e.g., BRFSS), and potentially other health data from the participating hospitals. These data sources will be supplemented with reviews of other existing reports and literature about Brooklyn (such as community needs assessments done by local elected officials and CBOs), and primary data collection performed by NYAM, including key informant interviews, focus groups, and surveys to create a preliminary, borough-wide picture of health needs and service gaps. NYAM will aggregate, analyze, and interpret this data.

Output and Deliverables - The CNA will culminate in a final report that includes the following, as per DOH requirements:A. Description of health care and community resources B. Description of the community to be servedC. Identification of the main health and health service challenges facing the communityD. Summary of the assets, resources and needs for DSRIP projects E. Summary chart of projects to be implemented F. Methodology, data, and communication with community stakeholders



Description

5.2)Characters used: 4026

Description

Needs Assessment Methodology

The community is defined as the population of Kings County (Brooklyn), with particular emphasis on the service areas of the emerging PPSs and community-based organization (CBO) partners and on neighborhoods with high numbers of Medicaid-eligible residents. To assess needs with a greater level of specificity, NYAM researchers will analyze available quantitative data at the zip code level. These analyses will include within borough comparisons, as well as comparisons to city and state indicators, so as to identify needs and gaps in care relative to other geographic and administrative entities.

Utilizing secondary source data to assess current resources and potential gaps in careMost existing demographic and health care utilization data is available at the zip code level, which will facilitate full use of existing data sets. Also, this level of specificity allows an analysis of neighborhoods and communities within the extremely diverse borough of Brooklyn. To assess need, researchers will consider, for example, prevalence of a disease within a given zip code and distance to particular provider types, so as to identify seeming access issues.

Defining measurements

NYAM will work with the PPS Steering Committee to identify appropriate indicators. NYAM will begin with an analysis of existing reports and data sources, including current CNA, CHNA, CHIPS and CSP from Brooklyn facilities, as well as their relevant health care utilization data. From this initial review and analysis, NYAM will create or modify service maps based on utilization data/patient sending statistics, and compile demographic profiles, with inclusion of demographic markers that relate to health risk factors, health status and disease prevalence. These profiles will illustrate potential health care needs and gaps at the zip code level.

This community needs assessment will review the metric sets for DSRIP for Domains 2. 3 and 4 to establish baselines and compare to both community level and state –level metrics and achievement as well as achievement by high performing systems - as a means to identify populations/areas that require specific focus.

Refining scope for further study and primary data collection

Although zip code level data is useful in identifying areas of potential gaps in care, concentrations of disease, and hotspots of preventable hospitalizations, NYAM also recognizes the limitations of this unit of measurement. Zip codes can be very diverse, and neighborhoods may cross zip codes. In addition, health care patterns don’t always neatly fall into geographies. Therefore, NYAM will work with the emerging PPSs Steering Committee to identify areas for more in-depth and focused data collection and to identify key community partners who may help us to access particular target populations to participate in focus groups and surveys.

Key Research Questions

The specific questions we seek to answer, with a particular focus on Medicaid and other low-income populations, through this research are:• To what extent are community and environmental conditions in Brooklyn conducive to health promotion and disease prevention?• What are the primary health concerns and health needs of Brooklyn residents, overall and according to neighborhood and socio-demographic characteristics?• What are the health related programming and services available to community residents, what organizations are providing the services, and what are the service gaps?



5.3)

Data Collection


Description

especially high needs. The data sources include:• the NYS Community Health Indicator Reports (to compare Brooklyn rates of chronic disease-specific morbidity, mortality, hospitalization and other indicators of poor health and associated health care utilization to the corresponding rates of NYC and NYS); • the Behavioral Risk Factor Surveillance System (BRFSS) (to compare demographic, health, health insurance and access measures for Brooklyn, NYC and NYS); • Prevention Quality Indicators (PQI) including preventable hospital admission rates (with observed and expected rate per 100,000 by PQI Name, allowing id of zip code areas with elevated rates and comparison to NYC and NYS); • the NYC Department of City Planning• Hospital-specific profiles of quality of care for selected conditions; • Medicaid chronic conditions, inpatient admissions, and emergency room visits data, by county and zip code, including counts of Medicaid beneficiaries;• Medicaid hospital inpatient Potentially Preventable Readmission (PPR) Rates by Hospital;• NYS Prevention Agenda 2013-2017 tracking indicators (which provides data for Brooklyn for a variety of health outcomes including rates of preterm birth, unintended pregnancy, maternal mortality, new HIV cases, new STI cases, immunization rates, obesity, and smoking);• the American Community Survey (to estimate demographic and income information by Zip Code Tabulation Area); • Other community reports such as Brooklyn Community Foundation Neighborhood Report, the CAMBA Annual Report, and the NYU Furman Center Brooklyn Housing Report.

Primary Data Collection and Analysis: Key Informant Interviews, Focus Groups, and Community Surveys

Based on initial reviews of secondary source data and our review of community reports, as well as steering group and community representative recommendations, we will conduct key informant interviews, focus groups, and surveys targeting specific areas and populations. Key informants will include health care providers and staff and leadership from community based organizations, including educational, service-related, religious, and cultural organizations. Key informant Interviews (approximately 10) will be conducted by NYAM staff, including executive leadership as appropriate. Focus groups (20 – 25 groups) will be conducted by NYAM staff, working in collaboration with community partners, as appropriate. Interviews and focus groups will address topics that include health and health care priorities, gaps in service and unmet needs, perceptions of available primary and specialty health care services, barriers and facilitators to accessing care, and health care service use. Recommendations regarding services and service delivery will be elicited during interviews and focus groups, including factors that might impact on development and implementation of programming and potential DSRIP projects.

So as to gather information from a broader section of the community, we will also develop brief “pencil and paper” surveys (estimated 10-15 minutes for completion) to be administered at local organizations, including faith institutions, senior centers, social service and health provider organizations, and other sites. At least 600 surveys will be collected. Surveys will be administered by trained data collectors, and will be offered in preferred languages. Surveys will cover topics similar to the focus groups and interviews.

Partnering with Community Based Organizations to ensure culturally appropriate focus group settings

NYAM will work collaboratively with CBOs and the CNA Steering Committee to identify target populations for the focus groups. To ensure that data are captured from a diverse set of community members and leaders, interviews and focus groups will be conducted in the primary languages spoken in the respective communities, where appropriate. If necessary, NYAM will subcontract with the CBOs to retain CBO representatives, fluent in primary languages,



5.4)

Reporting


The New York Academy of Medicine will aggregate and summarize the quantitative and qualitative data in a matter that is both intellectual rigorous, as well as accessible to a lay audience to enhance the ability to communicate it effectively to community partners. It’s also important to note that analysis of CNA data will start early in the data collection process and will be ongoing. Early and ongoing analysis will allow us to provide rapid feedback to PPS and community partners, ensure our methods are yielding useful data, allow for adjustments to the data collection protocol, and report on preliminary findings on a timely basis.

Secondary data: Once aggregated, quantitative data will be summarized first with descriptive statistics. More advanced techniques, including regression analysis, may be used to explore relationships between variables. Where possible, data will be presented in graphical (charts, line graphs, and mapping) format to facilitate ease of communication.

Focus group data: Key informant interviews and focus groups will be recorded and transcribed. NYAM research staff will develop a code list, based on the research questions and on the data gathered through the interviews and focus groups. The qualitative data will be managed and coded using NVivo, a qualitative software package. After study documents are coded, searches can extract appropriately coded excerpts into a single theme based report for analysis purposes. Analysis will rely on both inductive and deductive processes. More specifically, coded data will be analyzed for pre-identified themes consistent with the main research questions, and for themes deriving from the data themselves. Multiple members of the NYAM team will participate in the data analysis, as multiple perspectives facilitate a more thorough and less biased process. Summaries of the qualitative data will be organized by theme, with exemplary quotes used to illustrate and explain the summary information.

Survey data: Data collected through the community surveys will be entered into an access data base. It will be reviewed by the NYAM data analyst once 25 surveys have been completed, and on a regular basis, thereafter. Survey data will be analyzed at NYAM using SPSS (version 19). Descriptive statistics will be generated (e.g., proportions, means) to characterize the respondent population, their health status and health conditions, insurance status, and other key responses. Bivariate and multivariate analyses, consistent with the level of measurement, will be used to describe the relationships between variables and factors associated with key outcomes. Findings will be reported by theme, in both table and graph formats, allowing for the inclusion and presentation of analyses at varying levels of detail and complexity.

All the data will be summarized and compiled into borough-wide report that complies with all the NYSDOH requirements. Using a single report, rather than fragmented separate reports, will greatly enhance the emerging PPSs’ ability to communicate findings to appropriate parties. The emerging PPSs have longstanding relationships with community partners and will use the data-gathering process to grow and strengthen community ties. As part of these ongoing relationships, the emerging PPSs will communicate the findings of the CNA (including holding meetings with community partners to present findings) on an on-going basis. The assessment will also be made available online for comment. The emerging PPSs expect that this ongoing communication loop with community partners will help to refine focus areas, inform DSRIP project development, and define ongoing needs in the community over time.



Stakeholder Engagement

5.5) As an emerging Performing Provider System, please explain the process on how you plan to engage the key stakeholders to develop your DSRIP Project Plan? (Restricted to 3000 characters)

(Key stakeholders should not be a part of the emerging Performing Provider System) - See instructions for examples of key stakeholders


Stakeholder engagement is both a critical part of the community needs assessment process, as well as an ongoing activity by each of the PPSs as they move forward with DSRIP project planning. NYAM will engage stakeholders in the CNA process through the focus groups, key informant interviews and community survey as described above. In addition, each individual PPS will engage with community stakeholders as they develop their specific DSRIP projects. These stakeholders will be invited to participate in an advisory role in an ongoing manner in the development and operation of each PPS.

A preliminary list of stakeholders within the community is in the process of being identified by the PPSs. Through the course of the community needs assessment work, it is anticipated that other stakeholders will be identified for engagement. Preliminarily, the following individuals or groups have been identified for outreach: Borough President’s Office, City Council representatives, Community Board members, clergy from each faith representing large congregations, housing agency representatives (NYCHA), schools, homeless shelters, food banks/farmer’s markets, community outreach agencies, transportation services (MTA), health plans, welfare agencies, peer/family mental health advocacy organizations, family support organizations, programs for individuals with disabilities, youth development programs, libraries, universities, local governmental social service programs, immigrant service organizations, community based health education/social support/peer support programs (including those serving older adults, youth/adolescents, LGBT, veterans, active drug users), family support and training organizations, the local NAMI chapter, employment support services and similar organizations, including those serving persons with physical disabilities.


NYS DOH DSRIP_Project Design Grant Application Section 6 List of Vendors

List of Vendors

6.1)

1 Organization Name The New York Academy of Medicine 2 Organization Name PricewaterhouseCoopers LLPAddress City State Zip Code Address City State Zip Code

Organization Address 1216 Fifth Avenue New York NY 10029 Organization Address 300 Madison Avenue 24th Floor New York NY 10017Contact Person Anthony Shih, MD, MPH, Executive Vice President Contact Person Warren H Skea Principal

Contact Phone Number 212.822.7241 Extension: Contact Phone Number 214.682.7235 Extension:

Contact Email [email protected] Contact Email [email protected]

Characters used: 936 Characters used: 7063 Organization Name Sheppard, Mullin, Richter & Hampton LLP 4 Organization Name Kaufman Hall


Organization Address 30 Rockefeller New York NY 10112 Organization Address 5202 Old Orchard Road, Suite N700 Skokie IL 60077Contact Person Jay Gerzog Contact Person Charles Kim

Contact Phone Number 212.653.8465 Extension: Contact Phone Number 847.441.8780 Extension:


Characters used: 757 Characters used: 4935 Organization Name JL Consulting LLC 6 Organization Name Hogan Lovells


Organization Address 149 Windsor Avenue Rockville Centre NY 11570 Organization Address 555 Thirteenth Street, NW Washington DC 20004Contact Person John Lavan President and CEO Contact Person Cliff Stromberg

Contact Phone Number 516.536.3497 Extension: Contact Phone Number 202-637-5699 Extension:


Characters used: 579 Characters used: 777

Applicant must list contact information of any vendor they plan to contract with to assist in their DSRIP planning efforts. **The state maintains the right to approve any vendor used in the DSRIP program.**

Describe the vendor's

qualifications and how they will be

assisting the applicant in their planning efforts?

(Restricted to 1000 characters)

The New York Academy of Medicine (NYAM) will be supporting the Community Health Needs Assessment activities borough-wide for the DSRIP Design Grant efforts. Founded in 1847, NYAM addresses urban population health challenges through policy leadership, research, evaluation, education, and community engagement. Three NYAM departments will assist with planning efforts: The Center for Evaluation and Applied Research works with a broad range of organizations to investigate, assess and support the planning of initiatives that promote health and well-being; The Center for Health Innovation focuses on developing innovative and financially sustainable responses to the challenges of health care reform; The Department of Health Policy (DHP) facilitates community-based interventions to advance population health. Currently, DHP is working to assist health departments, hospitals, and community partners to advance the Prevention Agenda.





PricewaterhouseCoopers LLP (PwC) may facilitate and support the PPS' strategic initiative to develop an integrated delivery system, based on their Transform methodology - a methodology to approaching and delivering all aspects of consulting, from strategy through to implementation, accelerating the delivery of sustainable benefits to clients.The Transform methodology represents an enterprise approach to long-term, sustainable improvement that aligns people, process and technology across the enterprise to realize overall strategy. Transform focuses on five key activities across the different stages of a transformation project life cycle - Assess, Design, Construct, Implement, Operate and Review.





Through their work across the country, Sheppard Mullin has developed expertise in designing and implementing effective integrated delivery systems and innovative healthcare strategies to help healthcare providers and payors rise above the numerous and complex challenges that make healthcare delivery so difficult in our country today. Sheppard may lead the legal work related to creating an IDS for key leaders in this PPS.Sheppard has seen the difference that successes have made in improving people’s lives through enhancing access to high quality and cost effective healthcare and securing the long-term viability of AMCs, community hospitals and healthcare providers. They have particular expertise in underserved and underprivileged communities.





Kaufman Hall (KH) may provided financial advice as the PPS seeks to improve quality of care in the Borough of Brooklyn and create a sustainable platform for the providers going forward. Our first steps – to define the structure and governance of a new entity will be informed by rigorous financial planning which will be facilitated by KH in conjuction with JL Consulting, LLC. This will be a critical foundation to the ongoing effort of shaping and implementing the integrated health system.





JL Consulting, LLC is a health care consulting firm specializing in financial services and major restructuring assignments. The firm was founded in May 2001 and has conducted a broad range of financial services and healthcare restructuring engagements in more than 45 hospitals in the tri-state area, with the great majority of these engagements located in New York-based providers. JL Consulting has significant experience with the lead providers in this PPS and may serve as a financial advisor as the four leads create a common governance function and shared financial risk.





Hogan in a leading global law firm who has worked on dozens of integrated delivery system transactions among academic medical centers, community hospitals, and other organizations. The firm has a deep and talented bench in regulatory, transactional, tax, employment, anti-trust and other concerns related to the creation of an IDS. Additionally, Hogan has worked on numerous transactions with SUNY and understands the intracacies of working with New York State on these types of organizational deals. Hogan may advise SUNY on its role as the academic medical center of Brooklyn, how it can strengthen its ability to continue to provide the workforce of the future for Brooklyn, and continue to conduct cutting edge organizational, clinical, translational and basic research.


NYS DOH DSRIP_Project Design Grant Application Section 7 Design Grant Timeline

Design Grant Timeline7.1)

Date (MM/DD/YYYY) Action/Decision/MilestoneSupport and Application Requirement Milestones

7/15/2014 Decision Select consultant(s) to assist with the design of affiliation strategies7/15/2014 Decision Select legal counsel to advise on formation of the affiliation strategies

7/15/2014Decision Select of consultant to provide PMO funcitons and facilitate the development of DSRIP Project Plan

7/30/2014 Milestone Create summary level plan for contributing to and participating in DSRIP learning collaboratives

7/30/2014Action Develop strategic approach to convert to risk-based population health reimbursement across PPS

7/31/2014 Action Conduct monthly PAC meetings during design phase, beginning in July 20148/15/2014 Milestone Complete provider demographics of Project Plan8/30/2014 Action Draft charter articulating clear business relationship among all providing providers

8/30/2014Action

8/30/2014Action

9/30/2014 Milestone Complete PPS communication plan to support project implementation

9/30/2014Action

10/1/2014Milestone

11/30/2014

Milestone12/1/2014 Milestone Complete the DSRIP Face Sheet for each DSRIP project (including executive summary)12/1/2014 Action Draft evidence of public input into the development of the Project Plan

12/1/2014Milestone

12/1/2014Action

12/1/2014Action

12/1/2014Action

12/1/2014 Milestone Execute signed attestations of non-duplication by PPS members12/16/2014 Milestone Submit DSRIP Project Grant Application to New York State Department of Health

12/10/2014Milestone

Community Health Needs Assessment Milestones7/31/2104 Action Approve CHNA project work plan

9/30/2014

Decision10/30/2014 Milestone Complete Community Health Needs Assessment10/30/2014 Decision Confirm project details based on final CHNA

Project Milestones7/15/2014 Milestone Draft provider overarching goals for Project Plan

7/30/2014Milestone

9/30/2014Milestone

11/1/2014Milestone

12/1/2014 Milestone For CHNA adjusted/confirmed list of projects: complete 5-year budget for each project

12/1/2014Milestone

Description (Up to 1200 characters)

Establish a HIPAA-compliant data agreement among PPS participating providers to uniformly share and manage patient level data

Inventory enabling technology of participating providers to support community-based care, including EHR, HIX, and population health data platforms

Create DSRIP project resource matrix comparing resources contributed by participating providers against resource requirements needed to achieve metric targets and DSRIP goals

Complete assessment of financial stability of financially challenged safety-net and public providers within the PPS

Complete funds flow design for distributing incentive payments to participating providers; funds flow design will align payment levels with anticipating expenses while attaching internal PPS metrics to internal PPS payments to align participating provide performance with PPS performance targets

Draft expectation of sustainability including how gains can be continued after conclusion of project period as well as financial forecast of expected savings to Medicaid program

Create plan for reporting decision making, change management, and dispute resolution on performance and incentive payments

Establish methodology for developing and monitoring DSRIP project metrics and distributing results to appropriate participating providers to support rapid cycle evaluation

Create implementation plan for providing workforce training, including but not limited to selection of education partners and drafting curricula

Complete preliminary estimate of employees by job class requiring workforce training to transition to community-based roles including employment levels, wages and benefits, and distribution of skills

Based on interim feedback from CHNA, affirm that preliminary CHNA findings validate the DSRIP projects selected in the DSRIP Design Grant Application or require adjustment; Project Plan will provide evidence that the PPS has a clear understanding of the needs of the service area and that the project will address these needs in a significant manner

Complete identification of overarching provider goals for DSRIP Project, describe how this will create healthcare delivery system transformation in Brooklyn, and confirm with baseline metrics that project is relevant to goals for the PPS and service area

Draft rationale describing project choice and summary including citations of existing evidence showing that project can lead to improvement on goals of project

Draft formal PPS governance plan showing strong centralized project control and decision making authority; plan should address performance of lower performing members through progressive sanctions

For CHNA adjusted/confirmed list of projects: implementation plan with significant milestones for each project


NYS DOH DSRIP_Project Design Grant Application Section 7 Design Grant Timeline

Select OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect One


NYS DOH DSRIP_Project Design Grant Application Section 8 Data Request

Data Request

8.1) Please identify any additional data that would be helpful in completing your DSRIP Project Plan. For additional help, please see link below.

Type of Data

Medicaid Provider Network

Beneficiary Demographic Information

PPV / PQI Methodology or Software

Explanation of why this additional data will be helpful (Up to 1500 characters in each line)

Complete Medicaid Encounter Data for Area of Service (HIPAA Compliant)

Population Health Management will require a detailed charge level claims data on health care utilization of Medicaid populations across the service area. Planning for individual level project and needs assessment should be backed up by claims data including detailed diagnoses data which will allow PPS to program for high need disease types.

Funds Flow: Determination of a fair and equitable funds flow methodology during the design phase of this project will be based upon attributed lives contributed to the PPS by partner organizations. This approach to the funds flow methodology requires a reliable, precise, and unbiased data pool which is not available from any source but the State.

Listing of all Medicaid physicians including location (address), specialty type, hours of operation, physician identifiers will allow PPS to indentify gaps in provider network and expand access to primary and specialty care available in areas of need.

Gender, Age grouping for Medicaid Beneficiaries by Zip code will allow age adjustment for more accurate benchmarking of ED and Admission rates. Also knowing languages spoken by beneficiaries will illuminate possible gaps in ability to transmit often complicated health information. Will also help PPS to develope health communication tools that will be widely accessible to Medicaid beneficiaries.

In order to monitor the progress of the PPS the potentially preventable methodology for visits and admissions will allow tracking of interim progress towards goals, allow quick course correction if PPS believes targets will not be met.


NYS DOH DSRIP_Project Design Grant Application Section 8 Data Request

DSRIP Resources Link:See pages 87-92

https://www.health.ny.gov/health_care/medicaid/redesign/docs/waiver_amendment_update_present.pdf

https://www.health.ny.gov/health_care/medicaid/redesign/docs/waiver_amendment_update_present.pdf


NYS DOH DSRIP_Project Design Grant Application Section 9 Design Grant Budget

Design Grant Budget9.1)

* Only include direct expenses related to developing your DSRIP Project Plan application.

Budget Cost Category Amount

Community Needs Assessment Costs:Contractors/Vendors $ 400,000 Data Analysis

Other:

Total Community Needs Assessment Costs: $ 400,000

Stakeholder Engagement Costs:Advertising $ 20,000 Website Design $ 50,000 Meeting Costs $ 10,000

Other:

Total Stakeholder Engagement Costs: $ 80,000

Application Development Costs:Other: Project management, subject matter expertise, communic $ 1,400,000

Overarching DSRIP Planning $ 500,000

Total Application Development Costs: $ 1,900,000

Other Category:Develop an IDS $ 1,700,000

Total $ 1,700,000

Other Category:IT Assessment $ 400,000

Total $ 400,000

Grand Total $ 4,480,000



Capital Needs

9.2) Yes

If so, how much ? (Estimate): $ 1,184,000,000

If you selected 'Yes' or 'Maybe' in 9.2, please answer questions 9.3 and 9.4:

9.3)

Category Dollar Amount ($) Category Dollar Amount ($)Replacement hospital $ 700,000,000 Renovate hospital to create children's ho $ 250,000,000 Create 3 medical villages $ 60,000,000 Develop 12 ambulatory care sites $ 24,000,000 IT $ 50,000,000 Centralized Administration $ 100,000,000

9.4)

Does your emerging Performing Provider System anticipate needing capital funding to achieve the goals of your DSRIP Project Plan?

Please use the grid to state which types of costs the capital funds would be utilized for (e.g. construction, renovation) as well as approximately how much funding would be needed for each potential category.

Please describe which DSRIP projects these capital funds would be applied to and how the capital funds will help the emerging Performing Provider System achieve its project specific DSRIP objectives. (Restricted to 3500 characters)

The DSRIP projects selected in this application anticipate affiliation agreements (common leadership and financial risk) among several of the acute care providers. Funding is listed for a unified location for administrative offices for the to-be-formed Integrated Delivery System.

The medical village project will convert acute care facilities into space suitable for ambulatory care services and work flows. The medical village space will also need external access points that are suitable for such a setting. Acute care space may be converted to medical village standards at more than one location.

Connectivity among the various participating providers will require high performing linkages to a common Health Information Exchange, as well as EMRs at smaller providers that may not have installed them. HIX functionality will need to reach a maturity level that facilitates coordination of care among participating providers. It is anticipated that most providers will need to updgrade their access and data sharing capabilities to coordinate care, promote patient safety and engagement, and support reporting of metrics.

The common data warehouse will be required to segregate patients according to disease type, severity (at risk, rising risk) and other factors. Creating a soundly designed data platform will be necessary to support this work and will allow for effective interfaces with NY-SHIN, Healthix, and other initiatives. Additionally, medical management software that sits on top of the data warehouse will be required to maintain and execute work lists among providers across multiple organizations.


DSRIP Project Design Grant Application Updated Section 2 Form Partner Organization Contact Info

** Please read instructions for ease of use **

1 2

Organization Name

1 Lasante Community Services, Inc. NO2 Ditmas Park Care Center YES3 Premier HealthCare - Remsen Street YES4 Premier HealthCare - Nostrand YES5 St. Vincent's Services, Inc. (HeartShare St. Vincent's Services) YES6 HeartShare Wellness, Ltd. NO7 The Brookdale Hospital Medical Center YES8 Brookdale Family Care Center YES9 Brookdale Family Care Center YES

10 Brookdale Family Care Center YES11 Samuel Schulman Institute for Nursing and Rehabilitation YES12 Urban Strategies/Brookdale Family Care Center YES13 Rutland Nursing Home Co. Inc. YES14 Kingsbrook Jewish Medical Center YES15 Brownsville Multi-Service Health Center YES16 Community Healthcare Network, Inc NO17 Metropolitan Jewish Home Care Inc. d/b/a MJHS Home Care YES18 Menorah Home & Hospital for the Aged & Infirm d/b/a Menorah Center fo YES19 Metropolitan Jewish Home Care, Inc. (MJG Nursing Home Company LTHH YES20 Visiting Nurse Service of New York Home Care YES21 The Brooklyn Hospital Center YES22 Bedford Stuyvesant Family Health Center YES23 Crown Nursing and Rehabilitation Center YES24 Maimonides Medical Center YES25 Cobble Hill Health Center, Inc. NO26 Interfaith Medical Center YES27 New York Methodist Hospital YES28 Personal Touch Home Aides of NY YES

2.1) Partner Organizations - Contact Information General Provider Types

Fill out this form for the specific provider types we have listed in columns L & M

For all "Other" provider types, use the 2nd tab - Section 2.2_Partner Org_"Other".

SN Qualified (Y/N)



29 Personal Touch Home Care of NY, Inc. YES30 Hamilton Park Nursing & Rehabilitation Center YES31 Linden Center for Nursing and Rehabilitation YES32 Bedford Center for Nursing and Rehabilitation YES33 Crown Heights Center for Nursing and Rehabilitation YES34 Premier HealthCare - 34th Street Manhattan YES35 Premier HealthCare - Bayside YES36 Premier HealthCare - East Tremont YES37 Premier HealthCare - Astoria YES38 Young Adult Institute Inc. NO39 The Institutes of Applied Human Dynamics, Inc. YES40 Lifespire YES41 Lifespire - SPAN Mental Health Clinic YES42 HeartShare Human Services of New York YES43 SUS Developmental Disabilities Services, Inc. YES44 Community Programs of Westchester Jewish Community Services YES45 Occupations, Inc. YES46 Family Empowerment Council, Inc. (affiliate of Occupations, Inc.) YES47 Abundant Life Agency NO48 University Hospital of Brooklyn YES49 Coney Island Hospital YES50 Woodhull Medical and Mental Health Center YES51 Kings County Hospital Center YES52 Spring Creek Rehab NO53 Park Nursing Home NO54 Atrium Center for Rehabilitation and Nursing NO55 Queens medical Group YES56 SCO Family of Services-Nurses-Family Partnership YES57 Abundant Life Agency NO58 New Horizon Counseling Center, Inc./Case Management Program YES59 New Horizon Counseling Center, Inc./Central Avenue Clinic YES60 New Horizon Counseling Center, Inc./Day Treatment Program YES61 New Horizon Counseling Center, Inc./Far Rockaway Clinic YES62 New Horizon Counseling Center, Inc./Park Inn Home for Adults Clinic YES63 New Horizon Counseling Center, Inc./Ozone Park Clinic YES64 New Horizon Counseling Center, Inc./Wavecrest Home for Adults Clinic YES65 New Horizon Counseling Center, Inc./West Rockaway Clinic YES66 New Horizon Counseling Center, Inc./New Haven Manor for Adults Clinic YES67 New Horizon Counseling Center, Inc./OPWDD Program YES68 Linden Center for Nursing and Rehabilitation YES69 Bedford Center for Nursing and Rehabilitation YES70 Crown Heights Center for Nursing and Rehabilitation YES71 CHN Health Home NO72 Lutheran Medical Center YES73 Bushwick Center for Rehabilitation and Health Care YES74 Samuel Schulman Institute for Nursing and Rehabilitation YES75 Boro Park Center for Rehabilitation & Health Care YES76 Homefirst LHCSA, Inc. d/b/a MJHS License Home Care Services Agency YES77 New York Community Hospital of Brooklyn, Inc. YES78 Premier HealthCare - Remsen Street YES79 Lasante Community Services, Inc. YES80 Alpine Home Health Care YES



81 Terence Cardinal Cooke Health Care Center YES828384858687888990919293949596979899

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State of New York Department of Health

Delivery System Reform Incentive Payment (DSRIP) Program

3 4 5 6 7

Address City State Zip Person

673 Parkside Avenue Brooklyn NY 11226 Shabse Oberlander2107 Ditmas Avenue Brooklyn NY 11226 Shabse Oberlander

175 Remsen Street, 4th Floor Brooklyn NY 11201 Navneet Kathuria3364 Nostrand Avenue Brooklyn NY 11361 Navneet Kathuria

66 Boerum Place Brooklyn NY 11201 Mathew Smith177 Livingston Street, Lower Level Brooklyn NY 11201 Jude Alexandre, Senior Clinic Director

One Brookdale Plaza Brooklyn NY 11212 Jim Porter465 New Lots Ave. Brooklyn NY 11207 Wayne Gietz2554 Linden Blvd. Brooklyn NY 11208 Wayne Gietz

1095 Flatbush Ave. Brooklyn NY 11226 Wayne Gietz555 Rockaway Pkwy Brooklyn NY 11212 Genevieve Sorenson

1873 Eastern Parkway Brooklyn NY 11233 Wayne Gietz585 Schenectady Avenue Brooklyn NY 11203 Linda Brady, M.D.585 Schenectady Avenue Brooklyn NY 11203 Linda Brady, M.D.592 Rockaway Aevenue Brooklyn NY 11212 Harvey Lawrence

60 Madison Avenue, 5th Floor New York NY 10010 Elizabeth Howell440 9th Avenue, 14th Floor New York NY 10001Jay Gormley, VP of Planning, Research, and Innovation

1516 Oriental Blvd. Brooklyn NY 11235Jay Gormley, VP of Planning, Research, and Innovation6405 7th Avenue Brooklyn NY 11220Jay Gormley, VP of Planning, Research, and Innovation

1250 Broadway, 4th floor New York NY 10001 Sarah Larson121 DeKalb Avenue Brooklyn NY 11201 Joan Clark1456 Fulton Street Brooklyn NY 11216 Patricia Fernandez, MPA - President/CEO

3457 Nostrand Ave. Brooklyn NY 11229 Eric Kalt4802 10th Avenue Brooklyn NY 11219 David Cohen, MD380 Henry Street Broooklyn NY 11201 Anthony Lewis

1545 Atlantic Avenue Brooklyn NY 11213 Robert Mariani; Steve Korf506 Sixth Street Brooklyn NY 11215 Carol Vargas

2701 Emmons Ave Brooklyn NY 11233 Kurt H Leggard



186-18 HILLSIDE AVE Jamaica NY 11432 Kurt H. Leggard691 92nd Street Brooklyn NY 11228 Melissa Gugliemo CTRS, LNHA

2237 Linden Boulevard Brooklyn NY 11207 Melissa Gugliemo CTRS, LNHA40 Heyward Street Brooklyn NY 11211 Melissa Gugliemo CTRS, LNHA

810 St. Marks Avenue Brooklyn NY 11213 Melissa Gugliemo CTRS, LNHA406 10th Avenue, 9th Floor New York NY 10001 Navneet Kathuria

211-11 Northern Boulvard, 2nd Floor Bayside NY 11361 Navneet Kathuria3060 East Tremont Avenue, 2nd Floor Bronx NY 10461 Navneet Kathuria

37-11 35th Avenue Astoria NY 11101 Navneet Kathuria460 West 34th Street New York NY 10001 Marco Damiani

32 Warren Ave. Tarrytown NY 10591 Cara Levy1 Whitehall Street, 9th Floor New York NY 10004 Oonagh Christie

184-10 Jamaica Avenue Hollis NY 11423 Oonagh Christie12 MetroTech Center, 29th Fl. Brooklyn NY 11201 Linda Tempel

305 Seventh Avenue, 10th Floor New York NY 10001 Donna Colonna, Chief Executive Officer845 North Broadway White Plains NY 10603 Mary Grace Giuliano

15 Fortune Road West Middletown NY 10941Amy Anderson-Winchell, LCSW, Chief Executive Officer15 Fortune Road West Middletown NY 10941Amy Anderson-Winchell, LCSW, Chief Executive Officer

772 Vermont Street Brooklyn NY 11207 Olive Archer/Elzie Wright445 Lenox Road Brooklyn NY 11203 Franklin Campbell

2601 Ocean Parkway Brooklyn NY 11235Shirley Appelhans, Associate Executive Director760 Broadway, Brooklyn NY 11206Nancy Peterson, Senior Associate Director, Finance

451 Clarkson Avenue Brooklyn NY 11203Hope Mason, Deputy Executive Director, Strategic Planning660 Louisiana Avenue Brooklyn NY 11239 Manny Kaufman

128 Beach 115th Street NY Sue Zimet611 East 103rd Street Brooklyn NY 11236 Aaron Kaufman

89-31 161 Jamaica NY 11434 Dr Lewis Marshall 774 Saratoga Ave Brooklyn NY 11212 Maggie Petrosky

772 Vermont Street Brooklyn NY 11207 Olive Archer/Elzie Wright 115-02 Promenade Rockaway Beach NY 11694 Herrick Lipton

108-19 Rockaway Blvd Ozone Park NY 11420 Herrick Lipton720 Beach 20th Street Far Rockaway NY 11691 Herrick Lipton108-19 Rockaway Blvd Ozone Park NY 11420 Herrick Lipton

115-02 Promenade Rockaway Beach NY 11694 Herrick Lipton108-19 Rockaway Blvd Ozone Park NY 11420 Herrick Lipton242 Beach 20th Street Far Rockaway NY 11691 Herrick Lipton108-19 Rockaway Blvd Ozone Park NY 11420 Herrick Lipton

1526 New Haven Avenue Far Rockaway NY 11691 Herrick Lipton720 Beach 20th Street Far Rockaway NY 11691 Herrick Lipton2237 Linden Boulevard Brooklyn NY 11207 Morgan McCray

40 Heyward Street Brooklyn NY 11211 Morgan McCray810 St. Marks Avenue Brooklyn NY 11213 Morgan McCray

60 Madison Avenue, 5th Floor New York NY 10010 Elizabeth Howell150 55TH STREET Brooklyn NY 11220 Claudia Caine

50 Sheffield Avenue Brooklyn NY 11207 Isaac Rubin555 Rockaway Pkwy Brooklyn NY 11212 Genevieve Sorenson

4915 10th Ave Brooklyn NY 11219 Isaac Rubin6323 7th Avenue Brooklyn NY 11220 Jay Gormley

2525 Kings Highway Brooklyn NY 11229 Una Morrissey175 Remsen Street Brooklyn NY 11201 Navneet Kathuria

673 Parkside Avenue Brooklyn NY 11226 Shabse Oberlander4260 Bronx Blvd Bronx NY 10466 Isaac Rubin



1249 Fifth Avenue New York NY 10029 Neil Pollack



Assisted Living Facility

State of New York Department of Health

Delivery System Reform Incentive Payment (DSRIP) Program Critical Access Hospital (CAH)

Nursing Home

"OTHER" Providers - Fill out Section 2.2 8 9 10 11

Phone # Extension Email Provider Type

718-462-8432 [email protected] Diagnostic & Treatment Center (Non FQHC)718-462-8432 [email protected] SNF212-273-6381 [email protected] Diagnostic and Treament Center212-273-6381 [email protected] Diagnostic and Treament Center718-422-2315 8018 [email protected] Article 31 and Article 32 Clinic718-855-7707 8018 [email protected] Diagnostic & Treatment Center (Non FQHC)718-240-5000 5773 [email protected] Voluntary Hospital718-240-5001 5015 [email protected] Diagnostic & Treatment Center (Non FQHC)718-240-5002 5015 [email protected] Diagnostic & Treatment Center (Non FQHC)718-240-5003 5015 [email protected] Diagnostic & Treatment Center (Non FQHC)718-240-5004 5188 [email protected] SNF718-240-5005 5015 [email protected] Diagnostic & Treatment Center (Non FQHC)718-604-5211 [email protected] SNF718-604-5211 [email protected] Voluntary Hospital718-345-5000 1123 [email protected] Federally Qualified Healthcare Center (FQHC)212-545-2404 [email protected] FQHC212-356-5419 [email protected] CHHA212-356-5419 [email protected] SNF212-356-5419 [email protected] LTHHCP212-609-7563 [email protected] CHHA718. 250-8588 [email protected] Hospital347-464-6531 [email protected] FQHC718-535-5100 [email protected] SNF718-283-6392 [email protected] Voluntary Hospital

(718) 855-6789 145 [email protected] SNF718-613-4000 4003 [email protected] Voluntary Hospital718-780-3301 [email protected] Voluntary Hospital718-468-2500 1651 [email protected] CHHA

Provider Type: ONLY choose from the following:

Certified Home Health Agency

Diagnostic & Treatment Center (Non FQHC)

Federally Qualified Healthcare Center (FQHC)

Long Term Home Health Care Provider



718-468-2500 1651 [email protected] LTHHCP908-305-0594 [email protected] SNF908-305-0594 [email protected] SNF908-305-0594 [email protected] SNF908-305-0594 [email protected] SNF212-273-6381 [email protected] Diagnostic & Treatment Center (Non FQHC)212-273-6382 1021 [email protected] Diagnostic & Treatment Center (Non FQHC)212-273-6383 [email protected] Diagnostic & Treatment Center (Non FQHC)212-273-6384 [email protected] Diagnostic & Treatment Center (Non FQHC)212-273-6175 [email protected] OPWDD (Article 16 Provider)914-920-4238 [email protected] OPWDD (Article 16 Provider)212-741-0100 569 [email protected] OPWDD (Article 16 Provider)212-741-0100 569 [email protected] OMH (Article 31) Provider718-422-3306 [email protected] OMH (Article 31) Provider917-408-1600 [email protected] OPWDD (Article 16 Provider)914-761-0600 108 [email protected] OPWDD (Article 16 Provider)845-692-4454 7104 [email protected] OPWDD (Article 16 Provider)845-692-4454 7104 [email protected] OPWDD (Article 16 Provider)718-272-2363 [email protected] CHHA718-270-1000 8573 [email protected] Public Hospital718-616-5351 [email protected] Public Hospital718-963-6814 [email protected] Hospital718-245-3240 [email protected] Public Hospital718-669-7101 [email protected] SNF718-474-6400 [email protected] SNF917-232-9680 [email protected] SNF718-291-6161 [email protected] FQHC

[email protected] CHHA718-272-2363 [email protected] CHHA718-845-2620 [email protected] OMH (Article 31) Provider718-845-2620 [email protected] OMH (Article 31) Provider718-845-2620 [email protected] OMH (Article 31) Provider718-845-2620 [email protected] OMH (Article 31) Provider718-845-2620 [email protected] OMH (Article 31) Provider718-845-2620 [email protected] OMH (Article 31) Provider718-845-2620 [email protected] OMH (Article 31) Provider718-845-2620 [email protected] OMH (Article 31) Provider718-845-2620 [email protected] OMH (Article 31) Provider718-845-2620 [email protected] OPWDD (Article 16 Provider)718-684-2179 [email protected] SNF718-684-2179 [email protected] SNF718-684-2179 [email protected] SNF212-545-2404 [email protected] CHHA718-630-7300 [email protected] Voluntary Hospital917-618-4869 [email protected] SNF718-240-5000 5188 [email protected] SNF917-618-4869 [email protected] SNF212-356-5419 [email protected] LTHHCP718-692-5306 [email protected] Voluntary Hospital212-273-6381 [email protected] Diagnostic & Treatment Center (Non FQHC)718-462-8432 [email protected] Diagnostic & Treatment Center (Non FQHC)917-618-4869 [email protected] CHHA



212-360-3999 [email protected] OPWDD (Article 16) provider



OASAS (Article 32) Provider

OMH (Article 31) Provider

OPWDD (Article 16) provider

Public Hospital

Skilled Nursing Facility

"OTHER" Providers - Fill out Section 2.2 11 12 13 15 16

Provider Type MMIS OPCERT NPI #1 NPI #2

Diagnostic & Treatment Center (Non FQHC)673249 700139N 1497994800 1326140591

Diagnostic and Treament Center 1751000 7002154R 1760436190Diagnostic and Treament Center 1751000 7002154R 1760436190Article 31 and Article 32 Clinic 2993433 6739100A 1003015694Diagnostic & Treatment Center (Non FQHC) 2087016, 3123168 7001294R, 6470310 1326092396 1487895371

243572 7001002H 1346380870Diagnostic & Treatment Center (Non FQHC) 1681227 7001274R 1285758771Diagnostic & Treatment Center (Non FQHC) 1681227 7001274R 1336263813Diagnostic & Treatment Center (Non FQHC) 1681227 7001274R 1962459644

315857 7001318 1407842255 1831294636Diagnostic & Treatment Center (Non FQHC) 1734349 7001275R 1215984422

340845 7001033N 12453142852998745 7001033H 1356307656 1841465218

Federally Qualified Healthcare Center (FQHC) 7001256R 1578612413695941 7000119R 1477764496

2407638 7002656 1720019144708181 7001372N 1922004860353824 7001921L 1710149984

2996041 7002655 1528059805243614 7001003H 1326046467730483 7001243R 1033178561309559 7001367N 1508859687

2998736 7001020H 1093777492 10836231442997491 7001323N 1821049164734336 7001046H 1487724712 1588868889

2998805 7001021H 15483745491107648 7001625 1164401857

choose from the following:

Sole Community Provider (SCP)

Voluntary Hospital (Non CAH, Non Sole Community Provider)



1072480 0021L001 19321060103217407 7001034N 15788990761910865 7001397N 1134562853314443 7001387N 1356483580314627 7001367N 1831159664 1942648613

Diagnostic & Treatment Center (Non FQHC) 1751000 7002154R 1760436190Diagnostic & Treatment Center (Non FQHC) 1751000 7002154R 1760436190Diagnostic & Treatment Center (Non FQHC) 1751000 7002154R 1760436190Diagnostic & Treatment Center (Non FQHC) 1751000 7002154R 1760436190

1457354 6113310 11443145762000833 Many1500150 6136-000 1497709166347755 7526-100A 1164629788

1999339 ManyMany 1881816643

2005925 68270590ManyMany

9108L001 1992903736 19728325907001037H 1639179328 1285693275

246066 7001009H 1124032982698866 7001045H 1467469023246117 7001016H 1043224355

78124811780L001 14677521969108L001 1992903736 1972832590

13363472517442-101 1366430563

7442-300A 13664305637442-113 1366430563

7442-111A 13664305637442-100A 13664305637442-112A 13664305637442-005A 13664305637442-110A 1366430563

136643056301910865 7001397N 113456285300314443 7001387N 135648358000314627 7001367N 1831159664 19426486131102441 7002119R 19525180782996078 7001019H 1538111653 1811936529

7001364N 1225285513315857 7001318 1407842255 1831294636

7001394N 19829131091295L001 17101485497001008H 1215030697

Diagnostic & Treatment Center (Non FQHC) 1751000 7002154R 1760436190Diagnostic & Treatment Center (Non FQHC)

7000609 1912179763



3001829 6660100 1215100458



1 2

Organization Name

1 Young Adult Institute Inc. NO2 Homefirst LHCSA, Inc. d/b/a MJHS License Home Care Services Agency YES3 Elderplan Inc. YES4 VNSNY Hospice and Palliative Care NO5 Health Insurance Plan of Greater New York NO6 Brooklyn Jubilee NO7 MetroPlus Health Plan NO8 CAMBA, Inc. YES9 HealthPlus Amerigroup NO

10 Integra MLTC, Inc YES11 Primary Care Development Corporation NO12 Brooklyn Chamber of Commerce/Alliance NO13 Chinese Community Accountable Care Organization, Inc. YES14 Eastern Chinese American Physicians IPA NO15 CRVI YES16 Aetna NO17 UnitedHealthcare NO18 Brooklyn Perinatal Network, Inc. & The Brooklyn Task Force on Infant & M NO19 Caribbean Women's Health Association, Inc. NO20 PeerPlace Networks, LLC NO21 Fort Greene Sreategic Neighborhood Action Partnership NO22 Work Sites For Wellness NO23 New Dimensions In Care, Inc. NO24 Christopher Rose Community Empowerment Campaign, Inc. NO25 New York Integrated Network IPA, Inc. NO26 VIP Health Care Services, Inc. YES27 VIP Health Care Services, Inc. YES28 VIP Health Care Services, Inc. YES29 VIP Health Care Services, Inc. YES30 MJHS Hospice and Palliative Care YES31 Brooklyn Perinatal Network, Inc. & The Brooklyn Task Force on YInfant & NO32 Clergy United for Commuinity Empowerment,Inc NO33 Caribbean Women's health Association.Inc NO34 Work Site Wellness NO35 New Dimension in Care NO36 Community Programs of Westchester Jewish Community Services NO

2.2) Partner Organizations - Contact Information"OTHER" Provider Types

SN Qualified (Y/N)



37 Peerplace Network LLC NO38 Fort Greene Strategic Neighbourhood Action Partnership NO39 Diaspora Commuinty Services NO40 Cornell University Cooperative Extension -NYC NO41 Arthur Ashe Institute for Urban Health NO42 Hospice of New York, LLC YES43 Hospice of New York, LLC YES44 Hospice of New York, LLC YES45 Hospice of New York, LLC YES46 HeartShare Human Services of New York NO47 Family Empowerment Council, Inc. (Affiliate of Occupations, Inc.) NO48 Fort Greene Sreategic Neighborhood Action Partnership NO49 Occupations, Inc. NO50 SUS Developmental Disabilities Services, Inc. NO51 The Institutes of Applied Human Dynamics, Inc. NO52 South Brooklyn Medical Administrative Services, Inc NO535455565758596061626364656667686970717273747576777879808182838485868788



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3 4 5 6 7

Address City State Zip Person

460 West 34th Street New York NY 10001 Marco Damiani6323 7th Avenue Brooklyn NY 11220Jay Gormley, VP of Planning, Research, and Innovation6323 7th Avenue Brooklyn NY 11220Jay Gormley, VP of Planning, Research, and Innovation

1250 Broadway, 4th floor New York NY 10001 Sarah Larson55 Water St. New York NY 10041Patrick Wormser, Senior Director Hospital & Ancillary Contracting

c/o Flatbush Reformed Church, 890 Flatbush AvenueBrooklyn NY 11226 Chantal Hamlin160 Water Street NY NY 10038 Van Dunn, MD

1720 Church Avenue Brooklyn NY 11226 Joanne M. Oplustil/Kevin Muir9 Pine St. NY NY 10005 Justin Frazer

2701 Emmons Ave Brooklyn NY 11235 Elena Lowe22 Cortlandt Street NY NY 10007 Ronda Kotelchuck

335 Adams St., Suite 2700 Brooklyn NY 11201 Veronica Harris139 Centre Street, Suite 318 New York NY 10013 Dr. Josephine Wu

3370 Prince St, Suite 703 Flushing NY 11354 Alex Chan601 Stony Ford Road Middletown NY 10941Michael Mitchell, Deputy Executive Director of Program Services

100 Park Avenue New York NY 10017 John TesoroOne Penn Plaza, 8th Floor New York NY 10119 Megan Leese

76 Nevins Street Brooklyn NY 11217 Ngozi Moses, Executive Director3512 Church Ave Brooklyn NY 11203 Cheryl Hall300 Main Street East Rochester NY 14445 Todd Baitsholts

324 Myrtle Avenue Brooklyn NY 11205 Georgianna Glose, OP, DSW60 Pineapple St. #7D Brooklyn NY 11201 Marti Copleman772 Vermont Street Brooklyn NY 11207 Sharon Coombs-Rose772 Vermont Strret Brooklyn NY 11207 Sharon Coombs-Rose

12 MetroTech Center, 29th Floor Brooklyn NY 11201 Todd Pinkus116-12 Myrtle Ave Richmond Hill NY 11418 Robert Appel

492 Jerusalem Avenue Uniondale NY 11553 Robert Appel459 Main Street New Rochelle NY 10801 Robert Appel

NY Robert Appel39 Broadway New York NY 10006Jay Gormley, VP of Planning, Research, and Innovation76 Nevins St Brooklyn NY 11217 Ngozi Moses, Executive Director

172-17 Linden Blvd, 2nd Floor St Albans NY 11434 LaTonja Richardson 3512 Church Ave Brooklyn NY 11203 Cheryl Hall

60 Pineapple Street #7D Brooklyn NY 11201 Marti Copleman772 Vermont Street Brooklyn NY 11207 Sharon Combs rose

845 North Broadway White Plains NY 10603 Mary Grace Giuliano



300 main Street East Rochester NY 14445 Todd Baitsholt324 Myrtle Avenue Brooklyn NY 11205 Georgianna Glose, OP,DSW

182-4th Avenue Brooklyn NY 11217 Carine Jocelyn1337 President Street Brooklyn NY 11213 Marcia Blacl Peters 450 Clarkson Avenue Brooklyn NY 11203 Ruth C. Brown, ScD

45-18 Court Square, Suite 500 Long Island City NY 11101 John Diaz-Chermack45-18 Court Square, Suite 500 Long Island City NY 11101 Martha Heller, RN, CHPN45-18 Court Square, Suite 500 Long Island City NY 11101 Brad Markowitz45-18 Court Square, Suite 500 Long Island City NY 11101 Brenda Young, MS, RN, CHPN

12 MetroTech Center Brooklyn NY 11201 Linda Tempel15 Fortune Road West Middletown NY 10941 Amy Anderson-Winchell

324 Myrtle Avenue Brooklyn NY 11205 Georgianna Glose15 Fortune Road Middletown NY 10941 Amy Anderson-Winchell

305 Seventh Avenue New York NY 10001 Donna Colonna32 Warren Ave Tarrytown NY 10591 Cara Levy685 3rd Avenue Brooklyn NY 11232 Alexis Bosco, Director




8 9 10 11

Phone # Extension Email "OTHER"- Provider Type

212-273-6175 [email protected] Other212-356-5419 [email protected] Other212-356-5419 [email protected] Other212-609-7563 [email protected] Other646-447-0356 [email protected] Other718-310-7123 [email protected] Other212-908-8569 [email protected] Other718-287-2600 [email protected]/ [email protected] Other212-518-5212 [email protected] Other347-505-3457 [email protected] Other212 437-3917 [email protected] Other718-875-1000 127 [email protected] Other

OtherOther

845-695-2556 [email protected] Other212-457-0438 [email protected] Other212-912-4059 [email protected] Other718-643-8258 [email protected] Other718-826-2942 202 [email protected] Other585-645-2102 [email protected] Other718-694-6957 [email protected] Other718-858-4620 [email protected] Other718-272-2363 [email protected] Other718-272-2363 [email protected] Other917-993-4228 [email protected] Other718-847-9800 [email protected] Other718-847-9800 [email protected] Other718-847-9800 [email protected] Other718-847-9800 [email protected] Other212-356-5419 [email protected] Other718-643-8258 21 [email protected] Other718-297-0720 [email protected] Other718-826-2942 202 [email protected] Other718-858-4620 [email protected] Other718-272-2363 [email protected] Other914-761-0600 108 [email protected] Other

917-232-8322 [email protected] 718-321-8893 [email protected]



585-645-2102 [email protected] Other718-694-6957 drglose#fortgreenesnap.org Other718 399 0200 [email protected] Other718-363-1016 307 [email protected] Other718-270-3101 [email protected] Other347-226-4804 [email protected] Other347-226-4812 [email protected] Other914-843-9637 [email protected] Other347-226-4816 [email protected] Other718-422-3306 [email protected] Other845-692-4454 7104 [email protected] Other718-694-6957 [email protected] Other845-692-4454 7104 [email protected] Other917-408-1600 [email protected] Other914-920-4238 [email protected] Other718-788-2594 [email protected] Other



11 12 15 16

"OTHER"- Provider Type MMIS NPI #1 NPI #2

CBO 1457354 1144314576LHCSA 1710148549MLTCP 1790001626Hospice 1049476 1215928510Insurer

CBOMCO 894519

Care Management 1552134 1659594075MCO 1617894 1649254806MCO 1617894 1841615630

ConsultantGovernment

ACOIPACBO 1997997

InsurerInsurer

CBOCBO

IT ProviderCBOCBOCBO 1972753481CBOIPA

LHCSA 02118578 1831195874LHCSA 00722289 1093712564LHCSA 00785819 1508865122 1528362365LHCSA 00908636 1679579569

Hospice 1084573 1770669038CBOCBOCBOCBOCBO 1972753481CBO 2005925



IT ProviderCBOCBO

Education 111Non-Profit

Hospice 1792052 1013001197Hospice 1792052 1013001197Hospice 1792052 1013001197Hospice 1792052 1013001197

CBO 1999339CBOCBOCBOCBO 1881816643CBO 2000833CBO 2737286 1114093523


DSRIP Project Design Grant Application Section 2.3 IPA/Physician List

2.3) IPA/Physicians - Contact Information

Certified_Nurse_Midwife

Dentist State of New York Department of HealthNurse_Practitioner Delivery System Reform Incentive Payment (DSRIP) ProgramPhysician IPA/Physician ListPhysicians Assistant

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Physician Name NPI MMIS License # County Address City State Zip Contact Name Phone # Extension

1 UNIVERSITY PHYSICIANS OF BROOKLYN, INC. UNIVERSITY PHYSICIANS OF YES Kings 450 Clarkson Avenue Brooklyn NY 11203 Marilyn Vientos Sotiriadis 718-270-20252 Abrams, Charles Physician Department of Neurology YES 1144347410 01989968 193638 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-24303 Abrigo, Lourdes Physician Brooklyn Anesthesia Resear YES 1932192333 00198898 111101 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-73984 Agarwal, Sanjeev Physician University Orthopaedic Asso YES 1154487528 02899925 243989 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-221-52455 Akivis, Alla Physician Downstate Family Medicine YES 1720073976 02311062 225286 Kings 450 Clarkson Avenue Brooklyn NY 11203 Mark Hoglund 718-270-26976 Alfonso, Antonio Physician University Surgeons at Dow YES 1598760670 00217047 117277 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-26977 Altzman, Elana Physician Brooklyn Pediatric Associate YES 1033194576 01760769 205833 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-29578 Amend, James Physician Downstate Imaging YES 1649341637 00614526 231516 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-780-29399 Amendolia, Lisa Physician Brooklyn Anesthesia Resear YES 1619960028 01774592 201464 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333

10 Amodio, John Physician Downstate Imaging YES 1164486668 00834015 146767 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-160311 Anziska, Brian Physician Department of Neurology YES 1043205339 00222335 119014 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-243012 Anziska, Yaacov Physician Department of Neurology YES 1821161258 02911957 227772 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-243013 Apostol, Alexandru Physician Brooklyn Anesthesia Resear YES 1275526691 02112976 237325 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-833314 Arbenz-Canales, Erick Physician Brooklyn Anesthesia Resear YES 1396713327 01977866 267667 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-739815 Areman, Russell Physician Downstate Imaging YES 1457340556 02662884 230295 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-160316 Arica, Koray Physician Brooklyn Anesthesia Resear YES 1306170006 03366185 252040 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-833317 Asoma, Kichiemon Physician University Ophthalmic Consu YES 1457548497 03292977 242414 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-780-153018 Augenbraun, Michael Physician Downstate Internal Medicine YES 1184618332 01457230 167931 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-143219 Baird, Alison Physician Department of Neurology YES 1710009725 03063921 248616 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-243020 Balogun, Lola Physician Brooklyn Anesthesia Resear YES 1659524353 02339568 264449 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-739821 Bamgbola, Oluwatoyin Physician Brooklyn Pediatric Associate YES 1851369334 01025704 220028 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-471422 Banerji, Mary Ann Physician Downstate Internal Medicine YES 1790779957 01636464 138292 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-154223 Batuman, Olcay Physician Downstate Internal Medicine YES 1316931579 02544883 191131 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-108224 Bendo, Audree Physician Brooklyn Anesthesia Resear YES 1225021652 00891772 152905 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-833325 Bentsianov, Boris Physician Brooklyn ENT YES 1407816747 02212619 211012 Kings 450 Clarkson Avenue Brooklyn NY 11203 Billy Tang 718-780-149826 Bodis-Wollner, Ivan Physician Department of Neurology YES 1821083437 01109113 110205 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-243027 Borer, Jeffrey Physician Downstate Internal Medicine YES 1609963792 00572110 112183 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-108128 Boruk, Marina Physician Brooklyn ENT YES 1235166281 03233305 237406 Kings 450 Clarkson Avenue Brooklyn NY 11203 Billy Tang 718-270-159929 Brar, Amarpali Physician Downstate Internal Medicine YES 1104001718 03359006 269882 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-158530 Braun, Suzanne Physician University Orthopaedic Asso YES 1972597581 00970654 004061 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-204531 Briefel, Gary Physician YES 1801853304 03107953 252549 Kings 450 Clarkson Avenue Brooklyn NY 11203 Crandall, Josheila 718-270-158532 Bronshtein, Vadim Physician Brooklyn Pediatric Associate YES 1558696682 03166727 256335 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-191233 Brown, Clinton Physician Downstate Internal Medicine YES 1538153614 00942654 129798 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-172934 Bruno, Laura Physician Brooklyn Pediatric Associate YES 1750366787 01877870 211484 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-295735 Budzikowski, Adam Physician Downstate Internal Medicine YES 1790725125 02650493 219902 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-108136 Burack, Joshua Physician University Surgeons at Dow YES 1508844390 01166292 155307 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-198137 Butts, Sydney Physician Brooklyn ENT YES 1275560047 02433347 217102 Kings 450 Clarkson Avenue Brooklyn NY 11203 Billy Tang 718-270-470138 Cabassa, Jose Physician Department of Neurology YES 1760526164 03327382 262225 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-204239 Casimir, George Physician Downstate Mental Health As YES 1295949741 00861129 157032 Kings 450 Clarkson Avenue Brooklyn NY 11203 Lauren Gabelman 718-287-480640 Cavusoglu, Erdal Physician Downstate Internal Medicine YES 1417941683 01989826 185754 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-108141 Chadow, Hal Physician Downstate Internal Medicine YES 1669466835 01467183 174991 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-108142 Chao, Tsai Physician University Orthopaedic Asso YES 1609850668 01786901 181825 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-204543 Chari, Geetha Physician Department of Neurology YES 1912992538 02189013 254463 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-204244 Chee, Chung Physician Brooklyn Anesthesia Resear YES 1700870136 00557795 112065 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-780-170745 Chen, Qi Physician Downstate Imaging YES 1437238672 02339646 241888 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-160346 Chen, Ning Physician Downstate Pathology Group YES 1255590378 03518063 266311 Kings 450 Clarkson Avenue Brooklyn NY 11203 Linda McGuire 718-270-274447 Chernichenko, Natalya Physician Brooklyn ENT YES 1255500906 03570812 256339 Kings 450 Clarkson Avenue Brooklyn NY 11203 Billy Tang 718-270-470148 Choi, Woo Sung Physician Downstate Imaging YES 1083654958 02753428 226992 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-160349 Clarke-Moore, Andrea Physician Brooklyn Anesthesia Resear YES 1033306600 02969533 246134 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-833350 Cohen, Carl Physician Downstate Mental Health As YES 1811916331 00204013 112653 Kings 450 Clarkson Avenue Brooklyn NY 11203 Lauren Gabelman 718-270-180851 Corsaro, Maria Physician Downstate Imaging YES 1831181064 01976627 212120 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-160352 Cottrell, James Physician Brooklyn Anesthesia Resear YES 1528052966 00429034 120766 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333

Physicians Type: ONLY choose from the following:

Physician Type (See Instructions) Individual OR Group Name

SN Qualified (Y/N)

Downstate Internal Medicine Associates






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

53 Crummer, Richard Physician Downstate Family Medicine YES 1619961851 01471714 187414 Kings 450 Clarkson Avenue Brooklyn NY 11203 Mark Hoglund 718-270-269754 Danias, John Physician University Ophthalmic Consu YES 1780645473 01877985 204603 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 212-288-090555 Daniello, Joseph Physician Brooklyn Anesthesia Resear YES 1639171572 00854577 145402 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-833356 Dattner, Laura Physician Brooklyn Pediatric Associate YES 1700861267 02418899 223641 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-295757 DeHaan, Elliot Physician Downstate Internal Medicine YES 1629270459 03240975 247859 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-471458 DeHovitz, Jack Physician Downstate Internal Medicine YES 1962496141 01449063 145405 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-460859 Dela Pena, Margarita Physician Brooklyn Anesthesia Resear YES 1669647855 03374696 26880 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-833360 Delano, Barbara Physician Downstate Internal Medicine YES 1750375937 00162836 097022 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-158561 Delury, John Physician Downstate Internal Medicine YES 1679567754 02269001 219029 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-143262 Demetis, Spiro Physician Downstate Internal Medicine YES 1003800202 01608731 168398 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-182163 Deutsch, James Physician University Ophthalmic Consu YES 1427032655 01130327 162708 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-780-153064 Dhuper, Sarita Physician Brooklyn Pediatric Associate YES 1811905201 01605967 189413 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-471465 Dillon, Shavon Physician Downstate Internal Medicine YES 1578708210 03383153 260614 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-153166 Dimaculangan, Dennis Physician Brooklyn Anesthesia Resear YES 1780678128 02299374 237327 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-833367 Dimiceli, Kathryn Physician University Ophthalmic Consu YES 1427217512 02325928 272291 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-171468 Dinkevich, Eugene Physician Brooklyn Pediatric Associate YES 1487648101 01669194 199221 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-295769 Diraimo, Robert Physician University Surgeons at Dow YES 1639119100 02439912 210599 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-251570 Distant, Dale Physician University Surgeons at Dow YES 1285612077 01438926 190405 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-103571 Donat, Margaret Physician Downstate Family Medicine YES 1427042670 02380963 224630 Kings 450 Clarkson Avenue Brooklyn NY 11203 Mark Hoglund 718-270-269772 Dresner, Lisa Physician University Surgeons at Dow YES 1538147335 01780670 171496 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-316873 D'Souza, Antoni Physician Brooklyn Pediatric Associate YES 1255438263 02109442 219321 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-295774 Dubey, Gangacharan Physician Downstate Internal Medicine YES 1477547669 02267650 208687 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-182175 Dubrovskaya, Veronika Physician Downstate Internal Medicine YES 1952559965 03050924 238181 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-111276 Duncan, Albert Physician University Surgeons at Dow YES 1093719551 00984249 156062 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-197377 Duqmaq, Omar Nurse_Practitioner Brooklyn Anesthesia Resear YES 1245418706 03167526 335423 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-833378 Dvorkina, Olga Physician Downstate Internal Medicine YES 1639163835 02020675 208619 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-166279 Ednick, Mathew Physician Brooklyn Pediatric Associate YES 1295942266 03472924 234700 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-471480 Ehrenhaus, Michael Physician University Ophthalmic Consu YES 1609859123 02201150 219684 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-425-090381 Eilertson, Brandon Physician Downstate Internal Medicine YES 1922283597 01088155 274041 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-153182 Elliott, Michele Physician Brooklyn Pediatric Associate YES 1659393007 02699503 222314 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-471483 Elmalem, Valerie Physician University Ophthalmic Consu YES 1306022173 02325928 264799 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-171484 Faber, Eve Physician Downstate Family Medicine YES 1962496117 02048364 214840 Kings 450 Clarkson Avenue Brooklyn NY 11203 Mark Hoglund 718-270-269785 Fahmy, Samir Physician Downstate Internal Medicine YES 1831183599 02006366 212030 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-108186 Falb, Marjorie Physicians Assistant University Orthopaedics Ass YES 1164853610 02839792 016828 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-282-780087 Fecarotta, Christopher Physician University Ophthalmic Consu YES 1003072018 02325928 273302 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 646-682-919288 Feit, Alan Physician Downstate Internal Medicine YES 1245224716 00483165 130244 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-108189 Feola, Jeffrey Physician Downstate Mental Health As YES 1477586303 01977866 214502 Kings 450 Clarkson Avenue Brooklyn NY 11203 Lauren Gabelman 718-270-180890 Fisher, Stanley Physician Brooklyn Pediatric Associate YES 1851376321 00736681 147124 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-191191 Franciosa, Joseph Physician Downstate Internal Medicine YES 1588914410 02339426 263064 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-182192 Frankel-Ovitsh, Robin Physician Brooklyn Pediatric Associate YES 1093790560 01872619 209549 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-295793 Freedman, Jeffrey Physician University Ophthalmic Consu YES 1699758110 00224222 119508 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-171494 Fried, Elie Physician Brooklyn Anesthesia Resear YES 1003800467 01358236 185402 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-833395 Friedman, Eli Physician Downstate Internal Medicine YES 1407840986 00202020 080904 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-158596 Garrett, Michael Physician Downstate Mental Health As YES 1417160722 00227225 121229 Kings 450 Clarkson Avenue Brooklyn NY 11203 Lauren Gabelman 718-270-180897 Ginzler, Ellen Physician Downstate Internal Medicine YES 1952395618 00187586 106796 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-166298 Giridharan, Radha Physician Department of Neurology YES 1952396574 00711082 144831 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-204299 Glick, Sharon Physician Downstate Dermatology Con YES 1114911419 01840362 197400 Kings 450 Clarkson Avenue Brooklyn NY 11203 Nancy Mingoia 718-270-1230

100 Goldfisher, Rachelle Physician Downstate Imaging YES 1033345764 03288204 257873 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603101 Goldstein, Nira Physician Brooklyn ENT YES 1689658288 01822426 182933 Kings 450 Clarkson Avenue Brooklyn NY 11203 Billy Tang 718-270-4701102 Goracy, Alicja Physician Downstate Imaging YES 1780613612 02937222 192718 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-780-2939103 Gottesman, Susan Physician Downstate Pathology Group YES 1225013378 02544865 177948 Kings 450 Clarkson Avenue Brooklyn NY 11203 Linda McGuire 718-270-2744104 Goyal, Himani Physician University Ophthalmic Consu YES 1467637298 '03134989 237277 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-1714






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

105 Grant, Arthur Physician Department of Neurology YES 1649382961 02701637 236150 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-221-5188106 Greenberg, Oded Physician Downstate Imaging YES 1003892928 01774932 178096 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603107 Grossman, Evan Physician Downstate Internal Medicine YES 1932367331 03243354 241052 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-4772108 Guillen, Christina Physician Brooklyn Pediatric Associate YES 1730164203 02677287 235850 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-2957109 Gumbs, Ensor Physician Brooklyn Anesthesia Resear YES 1154506947 03394227 270924 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333110 Gupta, Raavi Physician Downstate Pathology Group YES 1760471627 03068281 262698 Kings 450 Clarkson Avenue Brooklyn NY 11203 Linda McGuire 718-270-2744111 Hamblin, Jeffrey Physician Infant & Child Learning Cent YES 1306823851 02378178 212404 Kings 450 Clarkson Avenue Brooklyn NY 11203 Susan Bewley 718-270-2598112 Hanna-Hindy, Kayane Physician Downstate Internal Medicine YES 1962664144 02339426 257103 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1112113 Hanson, Matthew Physician Brooklyn ENT YES 1982689014 01573399 193446 Kings 450 Clarkson Avenue Brooklyn NY 11203 Billy Tang 718-270-4701114 Hendrzak, Andrea Physician University Surgeons at Dow YES 1689865347 02923655 245507 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-1421115 Herman, Steven Physician University Surgeons at Dow YES 1255390787 01797837 106799 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-1973116 Herskowitz, Michael Physician Downstate Imaging YES 1073599239 00860971 138506 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603117 Hill, Constance Physician Brooklyn Anesthesia Resear YES 1134113525 00183495 105193 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333118 Hindi, Amjad Physician Downstate Mental Health As YES 1487854964 02946234 261600 Kings 450 Clarkson Avenue Brooklyn NY 11203 Lauren Gabelman 718-270-1808119 Hong, Joon Physician University Surgeons at Dow YES 1659359453 00424442 130520 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-1035120 Horowitz, Kenneth Physician University Ophthalmic Consu YES 1366426504 00339551 003008 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-1714121 Huberman, Harris Physician Brooklyn Pediatric Associate YES 1376628727 01577724 165995 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-2272122 Hughes, Lorenzo Physician Brooklyn Anesthesia Resear YES 1033230404 03384907 262001 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333123 Ibrahim, Aziz Physician Brooklyn Anesthesia Resear YES 1437143831 02377342 214593 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-7398124 Ibrahim, Zachary Physician Brooklyn Pediatric Associate YES 1205096708 03138447 241252 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714125 Irak Dersu, Inci Physician University Ophthalmic Consu YES 1477643963 03642133 271386 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-1714126 Jacobson, Elka Physician Brooklyn Pediatric Associate YES 1548396914 02940563 245692 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714127 Jalou, Sanaa Physician Brooklyn Anesthesia Resear YES 1699803775 02865456 272448 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333128 John, Devon Physician University Surgeons at Dow YES 1932196862 02497863 200975 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-1421129 Joks, Rauno Physician Downstate Internal Medicine YES 1770577447 01466788 176072 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-2156130 Jongco, Bienvenido Physician University Surgeons at Dow YES 1588728992 02339504 115171 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-1421131 Jose, Temitope Physician Brooklyn Pediatric Associate YES 1770578213 02588723 231948 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-2957132 Kalnins, Aris Physician Brooklyn Anesthesia Resear YES 1376709113 02339568 272691 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-7398133 Kantor, Alan Physician Downstate Imaging YES 1932100781 00988156 157418 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603134 Kassotis, John Physician Downstate Internal Medicine YES 1598759003 01755384 187961 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1081135 Kaufman, Stephen Physician University Ophthalmic consu YES 1558421958 02325928 273321 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-1714136 Kaufman, Daniel Physician University Surgeons at Dow YES 1215171566 03144149 238761 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-1421137 Kelly, Paul Physician Downstate Internal Medicine YES 1093919144 03272355 256887 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1432138 Khartoon, Bibi Physician Downstate Internal Medicine YES 1700870482 01761233 196476 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1540139 Khillan, Ratesh Physician Downstate Internal Medicine YES 1588869374 03151842 266181 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1082140 Kifle, Getahun Physician University Orthopaedic Asso YES 1932183258 01909351 209314 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-2045141 Killoran, Kathleen Physician Downstate Internal Medicine YES 1558551242 02339426 265238 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-4180142 Kolla, Srinivas Physician Downstate Imaging YES 1871535633 02931946 238079 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603143 Koziorynska, Ewa Physician Department of Neurology YES 1710997614 02800402 238157 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-2430144 Krant, Jessica Physician Downstate Dermatology Con YES 1275527582 02427576 220067 Kings 450 Clarkson Avenue Brooklyn NY 11203 Nancy Mingoia 718-270-1230145 Kwon, William Physician Downstate Imaging YES 1740440494 03165822 243515 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603146 Lai, Lawrence Physician Brooklyn Anesthesia Resear YES 1144556143 03374807 242655 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333147 Landesman, Sheldon Physician Downstate Internal Medicine YES 1770523698 01537177 134997 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1432148 Lauro, Helen Physician Brooklyn Anesthesia Resear YES 1063406452 02145288 206949 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333149 Lazar, Craig Physician Brooklyn Anesthesia Resear YES 1417941816 01367019 173669 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333150 Lazar, Jason Physician Downstate Internal Medicine YES 1295729721 01493787 196413 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1081151 Lazzaro, Douglas Physician University Ophthalmic Consu YES 1568445096 01566316 185979 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-780-1530152 Lee, Shin Physician Brooklyn Anesthesia Resear YES 1265426670 00312740 123546 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-7398153 Lee, Duck-Ja Physician Brooklyn Anesthesia Resear YES 1134121098 00681907 146835 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333154 Lee, Haesoon Physician Brooklyn Pediatric Associate YES 1659395358 00685447 129098 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714155 Lee, Roseanna Physician University Surgeons at Dow YES 1609037332 02339504 270154 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-6718156 Lee, Daniel Physician University Surgeons at Dow YES 1235386392 03037923 218996 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-1981






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

157 Lee, David Physician Downstate Internal Medicine YES 1225291685 03250873 235961 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-4772158 Lehto, Scott Physician Downstate Imaging YES 1770785321 03039943 230185 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603159 Lei, Baiping Physician Brooklyn Anesthesia Resear YES 1770759615 03327162 255128 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333160 Leonardo, Robert Physician Downstate Imaging YES 1164466637 01088155 218515 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-780-2939161 Levine, Steven Physician Department of Neurology YES 1407827546 02257927 223719 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-221-5188162 Liang, Lijin Physician Brooklyn Anesthesia Resear YES 1356325609 0207793 002482 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333163 Libien, Jenny Physician Downstate Pathology Group YES 1467552687 02847294 226077 Kings 450 Clarkson Avenue Brooklyn NY 11203 Linda McGuire 718-270-2744164 Lin, Jun Physician Brooklyn Anesthesia Resear YES 1174583298 02086400 217047 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333165 Lin, Alice Physician Brooklyn ENT YES 1336305028 02323435 270336 Kings 450 Clarkson Avenue Brooklyn NY 11203 Billy Tang 718-780-1498166 Linden, Craig Physician Downstate Imaging YES 1215992300 01909439 239108 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-780-2939167 Liu, Huntz Physician Downstate Imaging YES 1407832330 02109906 204401 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603168 Liverpool, Steven Physician Downstate Internal Medicine YES 1790779403 01692699 194009 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-493-5584169 Logginidou, Helene Physician Brooklyn Anesthesia Resear YES 1124119441 03305740 259335 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333170 Lokhandwala, Banu Physician Brooklyn Anesthesia Resear YES 1427042829 00416739 138932 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333171 Maccabee, Paul Physician Department of Neurology YES 1013902642 00596465 134603 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-2430172 Maciejka, Kate Physician Brooklyn Anesthesia Resear YES 1235123639 02576649 230022 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333173 Magee, Brian Physician Downstate Imaging YES 1942498878 02926901 246180 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603174 Mahajan, Swarn Physician Brooklyn Anesthesia Resear YES 1710989538 00230933 122904 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333175 Maheshwari, Aditya Physician University Orthopaedic Asso YES 1053512574 03313311 269870 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-2045176 Mahoney, James Physician Downstate Internal Medicine YES 1841285319 01398558 177624 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-3777177 Maldonado - Gonzalez, Ileana Physician Brooklyn Anesthesia Resear YES 1538355151 03373071 261206 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333178 Mallappallil, Mary Physician Downstate Internal Medicine YES 1578586392 02269776 215103 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1585179 Mammadova, Naila Physician Brooklyn Anesthesia Resear YES 1619144516 004018 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-7398180 Mangla, Sundeep Physician Downstate Imaging YES 1659357721 02086102 219126 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603181 Marchidann, Adrian Physician Department of Neurology YES 1790935294 03222819 263981 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-280-1124182 Markell, Mariana Physician Downstate Internal Medicine YES 1043204779 01081194 151748 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1585183 Marmur, Jonathan Physician Downstate Internal Medicine YES 1184619652 01351702 188907 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1081184 Mason, Catherine Physician Downstate Imaging YES 1700887569 02267090 179302 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603185 McFarlane, Samy Physician Downstate Internal Medicine YES 1902890528 01647439 192874 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-3711186 McNally, Lois Physician University Ophthalmic Consu YES 1053420299 01256904 157559 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 646-682-9192187 McSween, Tresa Physician Department of Neurology YES 1528053154 02440462 211463 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-2430188 Mehrazin, Mahsa Physician Department of Neurology YES 1841452851 03588929 260034 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-2430189 Mercado, Arlene Physician Brooklyn Pediatric Associate YES 1740354315 02816104 231220 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714190 Midura, Mieczyslaw Physician Brooklyn Anesthesia Resear YES 1932101912 00802626 115274 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333191 Millas, Themistocles Physician University Ophthalmic Consu YES 1568417640 02716769 006983 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-1714192 Miller, Scott Physician Brooklyn Pediatric Associate YES 1982689741 00669576 134294 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714193 Miller, Andrew Physician University Orthopaedic Asso YES 1801868419 02839792 168992 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-2045194 Min, Jae Physician Brooklyn Pediatric Associate YES 1932419017 03279081 258063 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-1912195 Mitchell, Judith Physician Downstate Internal Medicine YES 1750376125 01722256 180419 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1081196 Moallem, Hamid Physician Brooklyn Pediatric Associate YES 1013992494 01422884 183019 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714197 Mojdehi, Khosrow Physician Brooklyn Anesthesia Resear YES 1295729606 01201087 181512 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333198 Mon, Myat Physician University Surgeons at Dow YES 1447244900 02353717 207824 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-1421199 Mongia, Anil Physician Brooklyn Pediatric Associate YES 1245215441 02496711 267227 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714200 Mortati, Katherine Physician Department of Neurology YES 1740257393 02889976 235698 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-2430201 Murillo, Sharon Physician Brooklyn Anesthesia Resear YES 1972650760 '02588241 232560 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333202 Nakeshbandi, Mohamed Physician Downstate Internal Medicine YES 1871787812 02339426 270479 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1081203 Nathan, Radha Physician Brooklyn Pediatric Associate YES 1881672426 01972036 199656 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714204 Nicastri, Anthony Physician Downstate Pathology Group YES 1700861226 00827216 086879 Kings 450 Clarkson Avenue Brooklyn NY 11203 Linda McGuire 718-270-2744205 Ohemeng, Kwame Physician Brooklyn Anesthesia Resear YES 1649445362 03145402 245141 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333206 Ojeda-Martinez, Hector Physician Downstate Internal Medicine YES 1407091697 02339426 258994 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1432207 Olumba, Kenneth Physician University Ophthalmic Consu YES 1548438625 03265467 243898 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-1714208 Osborne, Rhonda Physician Downstate Imaging YES 1558391946 02092208 178214 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-780-2939






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

209 Ostrow, Steven Physician Downstate Imaging YES 1316948177 01118327 169271 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603210 Pandey, Nabendu Physician Brooklyn Anesthesia Resear YES 1366436784 00214457 115883 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333211 Park, Seung Physician University Orthopaedic Asso YES 1497739452 00231618 123206 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-2045212 Paulino, Carl Physician University Orthopaedic Asso YES 1881884468 02914689 240110 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-2045213 Perenyi, Agnes Physician Brooklyn Pediatric Associate YES 1689652299 01786218 194221 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-7207214 Perez, Sheila Physician Brooklyn Pediatric Associate YES 1588851539 03629563 258039 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714215 Perk, Jonathan Physician Department of Neurology YES 1275790842 03327382 259413 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-2502216 Persaud, Christine Physician University Orthopedics Asso YES 1497073274 02839792 272804 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-8045217 Phillips, Bradley Physician University Ophthalmic Consu YES 1104800143 01278495 184083 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-1714218 Pipia, Paul Physician University Orthopaedic Asso YES 1417931734 01474157 190390 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-2045219 Preibisz, Jacek Physician Downstate Internal Medicine YES 1003915745 01171553 164041 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1081220 Prospere, Everton Physician Downstate Internal Medicine YES 1497740807 02367173 226783 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1531221 Pulitzer, Steven Physician Downstate Imaging YES 1154515294 02956509 229127 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603222 Quale, John Physician Downstate Internal Medicine YES 1023003332 01906174 147500 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1432223 Rabinowitz, Simon Physician Brooklyn Pediatric Associate YES 1144314360 00983862 161072 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714224 Rao, Sreedhar Physician Brooklyn Pediatric Associate YES 1902884547 00207474 115364 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714225 Ravishankar, Jayashree Physician Downstate Internal Medicine YES 1649265950 02219074 232767 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1432226 Razov, Sergei Physician Brooklyn Anesthesia Resear YES 1598861031 219772 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333227 Reede, Deborah Physician Downstate Imaging YES 1639100084 00687105 137441 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-780-2939228 Reka, Safak Physician Downstate Internal Medicine YES 1538154844 02267678 207320 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-4772229 Resurreccion, Marilyn Physician Brooklyn Anesthesia Resear YES 1427042845 00207534 113736 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333230 Reznikov, Alexandra Physician Department of Neurology YES 1568421345 02737268 238867 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-2042231 Richards-Francois, Ella-Jean Physician Brooklyn Pediatric Associate YES 1316925951 01936218 212035 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-2957232 Rosenbaum, Daniel Physician Department of Neurology YES 1194802579 01084904 159885 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-2430233 Rosenfeld, Richard Physician Brooklyn ENT YES 1356360267 01376856 164941 Kings 450 Clarkson Avenue Brooklyn NY 11203 Billy Tang 718-780-1498234 Sadovsky, Richard Physician Downstate Family Medicine YES 1205820453 00233596 124601 Kings 450 Clarkson Avenue Brooklyn NY 11203 Mark Hoglund 718-270-2697235 Saha, Pamela Physician Downstate Mental Health As YES 1144274143 02341468 224845 Kings 450 Clarkson Avenue Brooklyn NY 11203 Lauren Gabelman 718-270-1808236 Salciccioli, Louis Physician Downstate Internal Medicine YES 1326033630 01113955 163907 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1081237 Salifu, Moro Physician Downstate Internal Medicine YES 1275528598 02242900 239060 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1585238 Samin, Amiram Physician Downstate Imaging YES 1790761807 01150536 158884 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603239 Saunders, Ramotse Physician Downstate Mental Health As YES 1609801059 02886395 253743 Kings 450 Clarkson Avenue Brooklyn NY 11203 Lauren Gabelman 718-270-1808240 Schoeneman, Morris Physician Brooklyn Pediatric Associate YES 1811974785 00210522 114864 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714241 Schreiber, Abraham Physician Brooklyn Anesthesia Resear YES 1417118035 03023470 246291 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333242 Schwartzman, Alexander Physician University Surgeons at Dow YES 1356329072 01101160 175677 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-1791243 Schwarz, Steven Physician Brooklyn Pediatric Associate YES 1801858345 00829016 126065 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714244 Scott, Wayne Physician University Ophthalmic Consu YES 1942274980 02312527 224580 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-1714245 Scott, Jinel Physician Downstate Imaging YES 1003847443 02829761 237071 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-780-2939246 Seligsohn, David Physician Brooklyn Anesthesia Resear YES 1447588389 03359437 259584 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333247 Serafini, Francesco Physician University Surgeons at Dow YES 1093046229 02339504 269445 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-6718248 Shao, Charles Physician Downstate Pathology Group YES 1033194568 219050 Kings 450 Clarkson Avenue Brooklyn NY 11203 Linda McGuire 718-270-2744249 Sharma, Anjali Physician Downstate Internal Medicine YES 1033193313 02686597 218707 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1432250 Shevde, Ketan Physician Brooklyn Anesthesia Resear YES 1891789152 01078211 111588 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333251 Shinder, Roman Physician University Ophthalmic Consu YES 1659578789 03233052 256559 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-1714252 Shrier, Eric Physician University Ophthalmic Consu YES 1720062037 02584921 219455 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna Yaou 718-270-1714253 Shulman, Abraham Physician Brooklyn ENT YES 1437187374 0118378 081566 Kings 450 Clarkson Avenue Brooklyn NY 11203 Billy Tang 718-270-4701254 Shwarzberg, Hyman Physician Downstate Imaging YES 1215913322 01445436 165162 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603255 Sidhu, Gurinder Physician Downstate Internal Medicine YES 1306031315 02931551 002939 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1082256 Silverman, Bernard Physician Downstate Internal Medicine YES 1033192836 143655 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-780-1435257 Silverman, Joshua Physician Brooklyn ENT YES 1821206269 03308394 259245 Kings 450 Clarkson Avenue Brooklyn NY 11203 Billy Tang 718-270-4701258 Soloman, Nancy Physician Downstate Internal Medicine YES 1073508099 01846377 202311 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1662259 Somasundaram, Mahendra Physician Department of Neurology YES 1053307686 00219618 117891 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-2430260 Somma, Jonathan Physician Downstate Pathology Group YES 1659501385 03151957 237685 Kings 450 Clarkson Avenue Brooklyn NY 11203 Linda McGuire 718-270-2744

00795079






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

261 Song, Mark Physician University Surgeons at Dow YES 1346227246 02094553 210025 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-2515262 Strashun, Arnold Physician Downstate Imaging YES 1578549689 00636219 138694 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603263 Subtirelu, Gina Physician Brooklyn Anesthesia Resear YES 1982752077 02134669 219748 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-7398264 Sundaram, Krishnamurthi Physician Brooklyn ENT YES 1306821921 00795111 137456 Kings 450 Clarkson Avenue Brooklyn NY 11203 Billy Tang 718-780-1498265 Suss, Amy Physician Brooklyn Pediatric Associate YES 1275511826 01879083 179617 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714266 Svyatets, Marina Physician Brooklyn Anesthesia Resear YES 1154315497 02144801 217006 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333267 Tablang, Prudencio Physician Brooklyn Anesthesia Resear YES 1821082173 00786498 140870 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-7398268 Taiwo, Evelyn Physician Downstate Internal Medicine YES 1699825638 03375335 260858 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1662269 Tak, Vinay Physician University Surgeons at Dow YES 1083694541 02770258 238034 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-270-1035270 Tawadrous, Hanan Physician Brooklyn Pediatric Associate YES 1346554060 03260515 257841 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714271 Tedla, Fasika Physician Downstate Internal Medicine YES 1760482822 02668537 222336 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1585272 Tehrani, Kayvon Physician University Surgeons at Dow YES 1346332301 02463385 214939 Kings 450 Clarkson Avenue Brooklyn NY 11203 Elaina Green 718-221-5087273 Thambireddy, Damodar Physician Brooklyn Pediatric Associate YES 1568541209 02624133 234477 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714274 Thornhill, Curtis Physician Brooklyn Anesthesia Resear YES 1649231283 01701301 199034 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333275 Tiao, Tommy Physician Brooklyn Anesthesia Resear YES 1487952768 03373333 259065 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-6324276 Toledano, Roulhac Physician Brooklyn Anesthesia Resear YES 1427270859 01701301 260125 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333277 Tropnas, Jean Physician Downstate Mental Health As YES 1720013295 '00727486 149642 Kings 450 Clarkson Avenue Brooklyn NY 11203 Lauren Gabelman 718-270-1808278 Twersky, Rebecca Physician Brooklyn Anesthesia Resear YES 1629062971 00959499 159609 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333279 Umpaichitra, Vatchrapan Physician Brooklyn Pediatric Associate YES 1770521205 02349957 252337 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714280 Urban, William Physician University Orthopaedic Asso YES 1114901709 01605485 191057 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-2045281 Uribe, Jaime Physician University Orthopaedic Asso YES 1174700496 02959617 256196 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-2045282 Valdez, Gloria Physician Brooklyn Anesthesia Resear YES 1740209568 00231883 123302 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333283 Valencia, Gloria Physician Brooklyn Pediatric Associate YES 1164400727 01108396 151068 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-1912284 Varghese, Leena Physician Brooklyn Anesthesia Resear YES 1982698163 02580550 232521 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-7398285 Vas, George Physician Department of Neurology YES 1578559134 00193480 109156 Kings 450 Clarkson Avenue Brooklyn NY 11203 Luis Perez 718-270-2430286 Vastardi, Maria-Anna Physician Downstate Internal Medicine YES 1255640181 03716901 254944 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-4772287 Vazirani, Tara Physician Brooklyn Anesthesia Resear YES 1447343504 00810935 156997 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-7398288 Velickovic, Ivan Physician Brooklyn Anesthesia Resear YES 1891789160 02673765 249250 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333289 Vignesh, Shivakumar Physician Downstate Internal Medicine YES 1033193891 274592 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1112290 Wadowski, Stephen Physician Brooklyn Pediatric Associate YES 1023095205 01636768 177699 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-2592291 Wagner, Lance Physician Brooklyn Anesthesia Resear YES 1720072911 01401298 186118 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333292 Waite, Stephen Physician Downstate Imaging YES 1619955283 2701086 235352 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603293 Walsh, James Physician Downstate Imaging YES 1649411901 03256677 252047 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603294 Weiss, Steven Physician Downstate Internal Medicine YES 1114912144 01454911 185492 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1432295 Wilson-Best, Noelle Nurse_Practitioner Brooklyn Anesthesia Resear YES 1174575807 02900998 304106 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-7398296 Maerz, Danielle Physician Downstate Internal Medicine YES 1245225598 02138943 084401 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-6320297 Wlody, David Physician Brooklyn Anesthesia Resear YES 1205820578 01401298 174515 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333298 Worah, Samrat Physician Brooklyn Anesthesia Resear YES 1972586451 02711948 258677 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333299 Xu, Jiliu Physician Brooklyn Pediatric Associate YES 1174769319 03243785 250994 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714300 Yager, Jessica Physician Downstate Internal Medicine YES 1922208743 03546783 266428 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-4180301 Yoshihara, Hiroyuki Physician University Orthopaedic Asso YES 1316102650 02839792 268249 Kings 450 Clarkson Avenue Brooklyn NY 11203 Annmarie Anishivilli 718-270-2045302 Yudis, Carmencita Physician Downstate Pathology Group YES 1588701908 02404355 131635 Kings 450 Clarkson Avenue Brooklyn NY 11203 Linda McGuire 718-270-2744303 Yusuff, Jameela Physician Downstate Internal Medicine YES 1124051388 02828095 231242 Kings 450 Clarkson Avenue Brooklyn NY 11203 Josheila Crandall 718-270-1432304 Zeleny, Betka Physician Brooklyn Anesthesia Resear YES 1669466934 00277770 134073 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-270-8333305 Zhang, YaoPing Physician Brooklyn Pediatric Associate YES 1932351285 00250361 250361 Kings 450 Clarkson Avenue Brooklyn NY 11203 William Dubritz 718-270-4714306 Zimbler, Nicoletta Physician Brooklyn Anesthesia Resear YES 1952640526 02339568 270240 Kings 450 Clarkson Avenue Brooklyn NY 11203 Evan Sottasanti 718-630-7398307 Zinn, Daniel Physician Downstate Imaging YES 1912983024 01178409 146766 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603308 Zinn, Harry Physician Downstate Imaging YES 1508842808 01689578 191697 Kings 450 Clarkson Avenue Brooklyn NY 11203 Donna McKenzie 718-270-1603309 South Brooklyn Medical Administrative Services, Inc South Brooklyn Medical Admin NO 1114093523 2737286 160310387 Kings 685 3rd Ave Brooklyn New York 11232 Alexis Bosco 718-788-2594 117310 Armando Aquino Physician South Brooklyn Medical Admin NO 1720182959 225049 1198331 Staten Island 220 Adams Ave Staten Island New York 10306 Alexis Bosco 718-788-2594 117311 Anthony Sgarlato Physician South Brooklyn Medical Admin NO 1235118530 1724541 Staten Island 355 Bard Ave Staten Island New York 10310 Alexis Bosco 718-788-2594 117312 Premier Healthcare Inc. Premier Healthcare Inc YES 1760436190 1751000 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

313 Adele Cavalli Physician Premier Healthcare Inc YES 1598894628 1751000 152280 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381314 Alan Liu Physician Premier Healthcare Inc YES 1326103581 1751000 218171 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381315 Amit Khaneja Physician Premier Healthcare Inc YES 1922261486 1751000 267473 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381316 Andrea Nichols Physician Premier Healthcare Inc YES 1053496422 1751000 207843 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381317 Anjani Bhatt Physician Premier Healthcare Inc YES 1215016431 1751000 145992 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381318 Anna Viron Dentist Premier Healthcare Inc YES 1548365539 1751000 051444 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381319 Arlene Garcia Physician Premier Healthcare Inc YES 1972523116 1751000 183278 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381320 Aruna Sheth Physician Premier Healthcare Inc YES 1962527861 1751000 156615 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381321 Asiya Kabir Physician Premier Healthcare Inc YES 1023261310 1751000 259371 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381322 Atsuko Ishikawa Physician Premier Healthcare Inc YES 1528070547 1751000 256052 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381323 Barnidele Ajayi Physician Premier Healthcare Inc YES 1417995978 1751000 259100 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381324 Benjamin Wong Dentist Premier Healthcare Inc YES 1679624639 1751000 047984 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381325 Charles Cartwright Physician Premier Healthcare Inc YES 1497833735 1751000 208582 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381326 Charles Kwak Physician Premier Healthcare Inc YES 1548270218 1751000 218069 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381327 Cindy Yueh Physician Premier Healthcare Inc YES 1710206529 1751000 272518 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381328 David Shuster Physician Premier Healthcare Inc YES 1205893146 1751000 003025 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381329 David Kaufman Physician Premier Healthcare Inc YES 1427050764 1751000 127315 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381330 Diane Chang Physician Premier Healthcare Inc YES 1588826168 1751000 257294 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381331 Diane Liu Physician Premier Healthcare Inc YES 1972704062 1751000 249453 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381332 Dmitry Shmerkovich Physician Premier Healthcare Inc YES 1043486285 1751000 258729 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381333 Dorit Ben-Moha Physician Premier Healthcare Inc YES 1831288851 1751000 209201 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381334 Edward Juhn Physician Premier Healthcare Inc YES 1114208931 1751000 263650 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381335 Elaine Goldstone Nurse_Practitioner Premier Healthcare Inc YES 1699008375 1751000 F337687 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381336 Eugenia Guz Physician Premier Healthcare Inc YES 1629126180 1751000 176066 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381337 Gershon Ney Physician Premier Healthcare Inc YES 1457349151 1751000 183541 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381338 Gus Monioudis Dentist Premier Healthcare Inc YES 1124005970 1751000 047166 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381339 Henry Abrams Physician Premier Healthcare Inc YES 1023006764 1751000 090368 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381340 Howard Fiedler Physician Premier Healthcare Inc YES 1770666133 1751000 217238 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381341 Ilana Slaff Physician Premier Healthcare Inc YES 1336353556 1751000 217045 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381342 Jon Michnovicz Physician Premier Healthcare Inc YES 1437151537 1751000 163890 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381343 Jung Mi Chang Physician Premier Healthcare Inc YES 1518982123 1751000 232833 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381344 Kusum Kathpalia Physician Premier Healthcare Inc YES 1861577298 1751000 146262 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381345 Lela Mayers Physician Premier Healthcare Inc YES 1306949664 1751000 216385 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381346 Lezli Braswell Physician Premier Healthcare Inc YES 1194722876 1751000 272137 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381347 Lora Wolk Physician Premier Healthcare Inc YES 1487813051 1751000 247835 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381348 Meg Allyn Krilov Physician Premier Healthcare Inc YES 1114989076 1751000 167289 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381349 Nancy Abdel-Wahab Physician Premier Healthcare Inc YES 1639207350 1751000 248552 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381350 Nirmala Mitra Physician Premier Healthcare Inc YES 1538235973 1751000 126205 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381351 Olga Steklova Physician Premier Healthcare Inc YES 1508866195 1751000 228780 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381352 Pascal Chrisphonte Physician Premier Healthcare Inc YES 1164671038 1751000 269270 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381353 Ranjani Lowe Physician Premier Healthcare Inc YES 1487613824 1751000 229079 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381354 Ramaseshu Anne Physician Premier Healthcare Inc YES 1871583641 1751000 211058 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381355 Randall Ross Physician Premier Healthcare Inc YES 1922150515 1751000 170811 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381356 Richard Mayer Physician Premier Healthcare Inc YES 1508917444 1751000 183636 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381357 Robert Marcus Physician Premier Healthcare Inc YES 1528123734 1751000 N003477 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381358 Roberto Cortez Physician Premier Healthcare Inc YES 1265429096 1751000 003909 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381359 Roey Pasternak Physician Premier Healthcare Inc YES 1598926446 1751000 259631 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381360 Sallie Jo Hadley Physician Premier Healthcare Inc YES 1407978786 1751000 204720 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381361 Salma Afroze Physician Premier Healthcare Inc YES 1912109604 1751000 243749 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381362 Steven Divack Physician Premier Healthcare Inc YES 1306939723 1751000 143879 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381363 Sun Won Dentist Premier Healthcare Inc YES 1194877423 1751000 053844 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381364 Sunil Desai Dentist Premier Healthcare Inc YES 1942363957 1751000 048637 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

365 Vasantha Badhey Physician Premier Healthcare Inc YES 1992876445 1751000 234622 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381366 Vatcharapan Umpaichitra Physician Premier Healthcare Inc YES 1770521205 1751000 252337 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381367 Warren Goodman Physician Premier Healthcare Inc YES 1558373217 1751000 003926 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381368 Wilma Spinner Nurse_Practitioner Premier Healthcare Inc YES 1457417974 1751000 380067 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381369 Yan Ling Gao Physician Premier Healthcare Inc YES 1326052994 1751000 220427 New York 460 West 34th Street, 9th Floor New York NY 10001 Navneet Kathuria 212-273-6381370 New York Community Hospital New York Community Hospit YES Kings Brooklyn NY371 Zurab Abayev Physician New York Community Hospit YES 1841283058 215612 Kings 6414 Bay Parkway Brooklyn NY 11204 718-234-6679372 Thomas Aiello Physician New York Community Hospit YES 1922129782 198895 Kings 7423 Shore Road Brooklyn NY 11209 718-836-2001373 Bernard Alter Physician New York Community Hospit YES 1497817696 139812 Kings 2350 Ocean Avenue, 1st Floor Brooklyn NY 11229 718-339-1110374 Lance Austein Physician New York Community Hospit YES 1366430969 184217 Kings 1913 Avenue Z Brooklyn NY 11235 718-934-6661375 Lucia Avany Physician New York Community Hospit YES 1538320494 Kings 4626 Bedford Avenue Brooklyn NY 11235 718-787-0100376 Isaia Avraham Physician New York Community Hospit YES 1043217185 188449 Kings 3019 Avenue U Brooklyn NY 11229 718-209-5127377 Abdo Balikcioglu Physician New York Community Hospit YES 1457366015 187411 Kings 1725 East 12 Street Suite 202 Brooklyn NY 11229 718-265-5858378 Jeffrey Ball Physician New York Community Hospit YES 1235195579 236005 Kings 154 Siixth Avenue Brooklyn NY 11217 718-780-5240379 Fara Bass Physician New York Community Hospit YES 1356331656 N005164 Kings 2381 East 29 Street Brooklyn NY 11229 718-743-1400380 Howard Baum Physician New York Community Hospit YES 1548241979 184624 Kings 476 Bay Ridge Parkway Brooklyn NY 11209 718-238-2661381 Yakov Beim Physician New York Community Hospit YES 1609971316 N005573 Queens 131-24 Rockaway Boulevard So. Ozone Park NY 11420 717-659-7166382 Jacquelin A. Belamy Physician New York Community Hospit YES 1609971316 204828 Kings 9613 Flatlands Avenue Brooklyn NY 11236 718-927-1355383 Inna Belder Physician New York Community Hospit YES 1609945815 N006244 Kings 305 Oceanview Ave. Brooklyn NY 11235 718-743-3100384 Igor Beneditsky Physician New York Community Hospit YES 1043396047 237675 Kings 2797 Ocean Parkway 2nd Flr. Brooklyn NY 11235 718-576-1212385 Asya Benin Physician New York Community Hospit YES 1326111550 154727 Kings 2116 Avenue P Brooklyn NY 11229 718-338-1616386 Robert Bennett Physician New York Community Hospit YES 1821419631 Kings 2493 Ocean Avenue Brooklyn NY 11229 718-332-2254387 Anna Bentsianov Physician New York Community Hospit YES 1669432746 202022 Kings 40 W. Brighton Avenue, St. 103 Brooklyn NY 11224 718-006-2260388 Marie Bentsianov Physician New York Community Hospit YES 1285631101 2107531 Kings 40 W. Brighton Avenue, St. 103 Brooklyn NY 11224 718-006-2260389 Ralph Benzakein, DPM Physician New York Community Hospit YES 1609873041 N003697 Kings 2241 Ocean Avenue Brooklyn NY 11229 718-998-1375390 Alex Bernstein Physician New York Community Hospit YES 1366753410 257078 Kings 3039 Ocean Parkway Brooklyn NY 11235 718-946-9070391 Meyor Beytelman Physician New York Community Hospit YES 1518991835 150837 Manhattan 201 East 19th Street New York NY 10003 718-377-2000392 Pushpa R. Bhansali Physician New York Community Hospit YES 1093741506 157768 Kings 2429 Ocean Avenue Brooklyn NY 11229 718-934-7770393 Ilya Bilik Physician New York Community Hospit YES 1093731374 199478 Kings 2912 Avenue X Brooklyn NY 11235 718-615-0162394 Howard Bleier Physician New York Community Hospit YES 1275664757 101672 Kings 1720 East 14th Street Brooklyn NY 11229 718-998-0330395 Ilya Blokh Physician New York Community Hospit YES 1942253414 17453 Kings 3319 Kings Highway, 1J Brooklyn NY 11234 718-676-4067396 Marlene Bonilla Physician New York Community Hospit YES 1588856546 N006419-1 Queens 93-17 Roosevelt Avenue Jackson Heights NY 11372 718-803-2700397 Zachary Brenner Physician New York Community Hospit YES 1265479539 217004 Kings 1309 Avenue P Brooklyn NY 11229 718-648-2162398 Gregory Brevetti Physician New York Community Hospit YES 1619950435 222936 Kings 8318 Fourth Avenue Brooklyn NY 11209 718-748-0500399 Matvey Brokhin Physician New York Community Hospit YES 1770615064 232962 Kings 3131 Kings Highway, Suite B10 Brooklyn NY 11234 347-462-9292400 Alfredo Castillo Physician New York Community Hospit YES 1033268776 113575 Richmond 126 Wieland Avenue Staten Island NY 13039 718-966-8120401 Eric K. Cha Physician New York Community Hospit YES 1174537229 196022 Manhattan 1049 Fifth Avenue, Suite 2C New York NY 10028 718-491-2222402 David Chafiian Physician New York Community Hospit YES 1013116839 230739 Kings 2405 Avenue P Brooklyn NY 11229 718-338-3200403 Adam Chalnick Physician New York Community Hospit YES 1467512418 n005735 Kings 2650 Ocean Parkway Brooklyn NY 11235 719-769-7800404 Mang-Shing L. Chan Physician New York Community Hospit YES 1235240144 135920 Kings 1225 Newkirk Avenue Brooklyn NY 11330 718-693-3000405 Irene Cherfas Physician New York Community Hospit YES 1083885412 MD446026 Kings 902 49th Street Brooklyn NY 11219 718-283-8000406 Leonid Chernobelsky Physician New York Community Hospit YES 1104955491 196218 Kings 150 Brighton 11th Street Brooklyn NY 11235 718-616-1622407 Barry A. Cohen Physician New York Community Hospit YES 1457398778 166879 Kings 151 West End Avenue Brooklyn NY 11235 718-934-1222408 Jeffrey M. Dacher Physician New York Community Hospit YES 1518058783 N004220 Kings 3901 Nostrand Avenue Brooklyn NY 11235 718-648-9104409 Mark Deshevskiy Physician New York Community Hospit YES 1649379934 223331 Kings 2646 East 14th Street Brooklyn NY 11230 718-646-3333410 Ilya Domnich Physician New York Community Hospit YES 1699793034 217873 Kings 1687 Ralph Avenue Brooklyn NY 11236 718-251-7191411 Alan Dosik Physician New York Community Hospit YES 1770534653 210889 Kings 506 6th Street Brooklyn NY 11215 718-780-5240412 David Dosik Physician New York Community Hospit YES 1528010386 187815 Kings 506 6th Street Brooklyn NY 11215 718-780-5240413 Stella Douros Physician New York Community Hospit YES 1649361072 189559 Kings 7501 6th Avenue Brooklyn NY 11236 718-238-2336414 Ewa D'Silva Physician New York Community Hospit YES 1730105255 5117 Richmond 10 Putters Court Staten Island NY 10301 718-720-8372415 Seymour L. Edelstein Physician New York Community Hospit YES 1639162647 118741 Kings 2382 East 13th Street Brooklyn NY 11229 718-646-8787416 Miron Fayngersh Physician New York Community Hospit YES 1902918279 197845 Kings 745 Ocean Parkway Brooklyn NY 11230 718-677-9700






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

417 Millie R. Fell Physician New York Community Hospit YES 1780607192 160237 Kings 2727 Ocean Parkway Brooklyn NY 11235 718-332-0444418 Bella Fridman Physician New York Community Hospit YES 1134181878 203852 Kings 342 Quentin Road Brooklyn NY 11233 718-339-7399419 Vladimir Fridman Physician New York Community Hospit YES 1538646595 241618 Kings 2468 Flatbush Avenue Brooklyn NY 11234 718-252-4765420 Abraham Fruchter Physician New York Community Hospit YES 1356413074 143914 Kings 3065 Brighton 5th Street Brooklyn NY 11235 718-769-3700421 Elie Fteha Physician New York Community Hospit YES 1154493575 229384 Kings 440 Avenue U Brooklyn NY 11223 718-627-8700422 Alber Ftiha Physician New York Community Hospit YES 1174634687 228860 Kings 440 Avenue U Brooklyn NY 11223 718-627-8700423 Faraj Gadee Physician New York Community Hospit YES 1013026277 218041 Kings 1725 East 12th Street, Suite 202 Brooklyn NY 11229 718-259-9700424 Mark Galperin Physician New York Community Hospit YES 1760424543 211587 Kings 2829 Ocean Parkway, 2nd Fl. Brooklyn NY 11235 718-743-0900425 Richard Gasalberti Physician New York Community Hospit YES 1487809232 176219 Queens 11-20 Queens Boulevard Forest Hills NY 11375 718-544-7700426 Boris L. Galfand Physician New York Community Hospit YES 1982779708 158893 Kings 1740 East 13th Street Brooklyn NY 11229 718-376-4300427 Mark H. Genovesi Physician New York Community Hospit YES 1578582292 181571 Kings 8318 Fourth Avenue Brooklyn NY 11209 718-748-0500428 Neelofar Ghazanwi Physician New York Community Hospit YES 1184814048 242837 Kings 902 49th Street Brooklyn NY 11209 718-283-8912429 Anup R. Gheewala Physician New York Community Hospit YES 1811986458 176240 Kings 2818 Ocean Avenue, Ste. 7 Brooklyn NY 11235 718-616-2330430 Irene Gladstein Physician New York Community Hospit YES 1811171770 229431 Kings 2076 East 13th Street Brooklyn NY 11229 718-382-7900431 David Gleitman Physician New York Community Hospit YES 1790840486 N003089 Kings 1532 Flatbush Avenue Brooklyn NY 11234 718-434-0007432 Louis Glodowski Physician New York Community Hospit YES 1477508158 143924 Kings 532 Neptune Avneue, Ste 209 Brooklyn NY 11224 718-449-8860433 Joel M. Goldman Physician New York Community Hospit YES 1477636720 120880 Kings 1 Brookdale Plaza, Ste 101A Brooklyn NY 11212 718-240-5378434 Ravindra Goyal Physician New York Community Hospit YES 1962446906 129597 Kings 1640 Ocean Avenue Brooklyn NY 11230 718-377-8282435 Eliezer Greenberg Physician New York Community Hospit YES 1275648602 N005240 Kings 1405 46th Street Brooklyn NY 11219 718-438-8717436 Mikhail Grinberg Physician New York Community Hospit YES 1013917400 172662 Kings 1660 E. 14th Street, Ste. 302 Brooklyn NY 11229 718-382-8500437 Maria Grohovsky Physician New York Community Hospit YES 1275635963 210629 Kings 1811 Quenton Road, 1H Brooklyn NY 11229 718-336-3500438 Igor Grossman Physician New York Community Hospit YES 1366783417 239458 Kings 3019 Avenue U Brooklyn NY 11229 718-934-1800439 Constantino V. Gulmatico Physician New York Community Hospit YES 1225038375 149265 Kings 3103 Emmons Avenue Brooklyn NY 11235 718-258-4848440 George G. Gusset Physician New York Community Hospit YES 1245302322 086864 Kings 2815 Ocean Parkway Brooklyn NY 11235 718-769-9595441 Marc Gventer Physician New York Community Hospit YES 1821093840 N002605 Kings 2965 Ocean Parkway Brooklyn NY 11235 718-265-1140442 Aleksandr Heissman Physician New York Community Hospit YES 1245302322 199971 Kings 3045 Ocean Parkway Brooklyn NY 11235 718-449-1705443 Pierre Hindi Physician New York Community Hospit YES 1164605903 253104 Kings 2211 Emmons Avenue Brooklyn NY 11235 718-368-2960444 Leslie L. Honkiman Physician New York Community Hospit YES 1538187273 101879 Kings 2281 Ocean Parkway Brooklyn NY 11223 718-375-2777445 Onyekachi Ifudu Physician New York Community Hospit YES 1073551966 176905 Kings 1915 Ocean Avenue Brooklyn NY 11230 718-258-7700446 Yelena Ilina Physician New York Community Hospit YES 1609841741 197447 Kings 2589 Coney Island Avenue Brooklyn NY 11223 718-368-3698447 Alexey Isakov Physician New York Community Hospit YES 1093798746 197260 Kings 134 Brighton 11th Street Brooklyn NY 11235 718-616-1626448 Konstantinos Kallinikos Physician New York Community Hospit YES 1073505343 N005435 Kings 532 Neptune Aveneu, Ste 203 Brooklyn NY 11224 718-996-6000449 Habib Kamkhaji Physician New York Community Hospit YES 1003862657 218213 Manhattan 1787 Madison Avenue, Ste 50C New York NY 10035 212-348-9400450 Nickolay Kapitanov Physician New York Community Hospit YES Kings 2650 Ocean Parkway Brooklyn NY 11235 718-769-7800451 Yakoub Katri Physician New York Community Hospit YES 1205049962 240768 Kings 440 Avenue U Brooklyn NY 11223 718-627-8700452 Alex Katz Physician New York Community Hospit YES 1396876546 N005336 Kings 1309 AVenue P, (lower level) Brooklyn NY 11229 718-615-4444453 Victor Katz Physician New York Community Hospit YES 1649261074 196745 Kings 3632 Nostrand Avenue Brooklyn NY 11229 718-336-2259454 Hal J. Kazdin Physician New York Community Hospit YES 1174686232 145170 Kings 90 Brighton 11th Street Brooklyn NY 11235 718-332-7770455 Paul Kesselman Physician New York Community Hospit YES 1508011248 N003251 Kings 1203 Avenue J, Ste. 3A Brooklyn NY 11230 718-338-7878456 Shaya Khabyeh Physician New York Community Hospit YES 1346299047 Kings 645 Crawford Avenue Brooklyn NY 11223 718-368-2722457 Sultan Khan Physician New York Community Hospit YES 1740364504 193824 Kings 1602 Quentin Road Brooklyn NY 11229 718-645-7105458 Yelena Khaysman Physician New York Community Hospit YES 1598920019 Kings 3045 Ocean Parkway Brooklyn NY 11235 718-449-1705459 Igor Khelemsky Physician New York Community Hospit YES 1962431148 196963 Kings 2310 65th Street Brooklyn NY 11204 718-376-3200460 Boris Khorets Physician New York Community Hospit YES 1619989514 205586 Kings 2912 Avenue X Brooklyn NY 11235 718-615-0162461 Tatiana Khrom Physician New York Community Hospit YES 1184739799 227196 Kings 2792 Ocean Parkway, 3rd Fl. Brooklyn NY 11235 718-615-4000462 Alice Kim Physician New York Community Hospit YES 1154523553 50478 Kings 902 49th Street Brooklyn NY 11209 718-283-8000463 Ralph R. Kiriat Physician New York Community Hospit YES 1841299104 148276 Kings 3588 Nostrand Avenue Brooklyn NY 11229 718-891-7400464 Igor Kletsman Physician New York Community Hospit YES 1447297858 237033 Manhattan 416 East 76th Street, 4th Fl. New York NY 10021 212-434-5680465 Mark Koser Physician New York Community Hospit YES 1770581688 169168 Richmond 3611 Richmond Avenue Staten Island NY 10312 718-966-7200466 Oleg Kotelskiy Physician New York Community Hospit YES 1508907510 205059 Kings 3816 Nostrand Avenue Brooklyn NY 11235 347-713-6871467 Leonid Kozer Physician New York Community Hospit YES 1396798872 210014 Kings 1412 East 9th Street Brooklyn NY 11230 718-375-2825468 Isaac Kreizman Physician New York Community Hospit YES 1497825434 206647 Kings 5223 9th Avenue Brooklyn NY 11220 718-431-2959






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

469 Michael Krysko Physician New York Community Hospit YES 1295998532 Kings 3045 Ocean Parkway Brooklyn NY 11235 718-449-1705470 Thomas Larkin Physician New York Community Hospit YES 1487670436 177786 Kings 1503 Gravesend Neck Road Brooklyn NY 11229 718-382-6315471 Aleksander Lavrenov Physician New York Community Hospit YES 1992937379 6226 Kings 1401 Elm Avenue, Ste D Brooklyn NY 11230 917-687-7528472 Nathan Levin Physician New York Community Hospit YES 1588749527 184834 Kings 3632 Nostrand Avenue, 3rd Fl. Brooklyn NY 11229 718-743-7700473 Shauna Lewis Physician New York Community Hospit YES 1871563221 N005983 Kings 540 East 43rd Street Brooklyn NY 11203 718-451-1206474 Stephen M. Lichter Physician New York Community Hospit YES 1043241276 127425 Kings 2935 Avenue S Brooklyn NY 11229 718-616-0801475 Lee Guiok Lim Physician New York Community Hospit YES 1386636546 119214 Kings 80 Westminster Road Brooklyn NY 11218 718-462-9494476 Ming Liu Physician New York Community Hospit YES 1568548295 216567 Kings 1 Brookdale Plaza Brooklyn NY 11212 718-240-5321477 Alexander Losev Physician New York Community Hospit YES 1992732234 20203 Kings 2935 Avenue S Brooklyn NY 11229 718-616-0801478 Sergey Losyev Physician New York Community Hospit YES 1205831450 N005775 Kings 2005 Ocean Avenue Brooklyn NY 11230 718-645-4324479 Edmund Mandel Physician New York Community Hospit YES 1972531366 150681 Kings 3041 Avenue U #2 Brooklyn NY 11229 718-692-0020480 Mervat Mansour Physician New York Community Hospit YES 1053319962 220228 Kings 3131 Kings Hwy. Suite B8 Brooklyn NY 11234 718-377-2834481 Jeffrey Marc Physician New York Community Hospit YES 1962578229 144388 Kings 1711 Sheepshead Bay Road Brooklyn NY 11235 718-332-7717482 Alexander Marinbakh Physician New York Community Hospit YES 1043215320 211186 Kings 2844 Ocean Parkway, Suite 5 Brooklyn NY 11235 718-646-0909483 Boris Mazarov Physician New York Community Hospit YES 1203119037 Kings 3049 Brighton 6 Street Brooklyn NY 11235 718-368-1170484 Reuven Moshenyat Physician New York Community Hospit YES 1598719585 235361 Kings 2044 Ocean Avenue-Ste A-3 Brooklyn NY 11230 718-645-8901485 Yitzchak Moshenyat Physician New York Community Hospit YES 1528012259 235908 Kings 2044 Ocean Avenue-Ste A-3 Brooklyn NY 11230 718-645-8901486 Sam Moskowitz Physician New York Community Hospit YES 1912105321 131584 Kings 2035 Ralph Avenue, Suite A2 Brooklyn NY 11234 718-338-2621487 Suresh Nahata Physician New York Community Hospit YES 1033139803 160237 Kings 200 Brighton 15 Street, Apt. 3F Brooklyn NY 11235 917-596-7193488 Zaki Nakach Physician New York Community Hospit YES 1861576621 183340 Kings 1309 Avenue P Brooklyn NY 11229 718-375-6100489 Harout Nalbandian Physician New York Community Hospit YES 1801998505 142231 Kings 231 South 3rd Street Brooklyn NY 11221 212-529-1818490 Alex Natanzon Physician New York Community Hospit YES 1467613281 237360 Kings 445 Kings Highway, 2nd Floor Brooklyn NY 11232 718-645-0300491 Shahrzad Nazarian Physician New York Community Hospit YES 1760522791 N005761 Kings 2083 East 53rd Place Brooklyn NY 11234 718-258-2500492 George Neiderman Physician New York Community Hospit YES 1346328713 184789 Kings 3915 Avenue V, Ste 104 Brooklyn NY 11234 718-252-8440493 Howard Newhouse Physician New York Community Hospit YES 1427000256 177990 Kings 2405 Avenue P Brooklyn NY 11229 718-338-3200494 Stanley Newhouse Physician New York Community Hospit YES 1265400048 083819 Kings 2405 Avenue P Brooklyn NY 11229 718-338-3200495 Steven Newman Physician New York Community Hospit YES 1982779070 179517 Kings 449 Bay Ridge Parkway Brooklyn NY 11209 718-836-1343496 Leon Nitkin Physician New York Community Hospit YES 1811017916 161521 Kings 1120 Brighton Beach Ave. #60 Brooklyn NY 11235 718-646-3750497 Raisa Novofastovsky Physician New York Community Hospit YES 1710950878 N004903 Kings 1812 Quentin Road Suite M2 Brooklyn NY 11229 718-382-1773498 Parirokh Nozad Physician New York Community Hospit YES 1164507232 119601 Kings 2513 East 12 St. Brooklyn NY 11235 718-332-5009499 Steve Nozad Physician New York Community Hospit YES 1962587030 148878 Kings 2513 East 12 St. Brooklyn NY 11235 718-332-5009500 Stephen Oddo Physician New York Community Hospit YES 1114947207 195022 Kings 914 Bay Ridge Parkway Brooklyn NY 11228 718-748-5700501 H. Barry Opell Physician New York Community Hospit YES 1811041981 121684 Kings 2350 Ocean Ave. Brooklyn NY 11229 718-376-3300502 Aleksandr Orlovskiy Physician New York Community Hospit YES 1457501447 250379 Kings 2912 Avenue X Brooklyn NY 11235 718-615-0162503 Yefim Ornstein Physician New York Community Hospit YES 1023050473 218264 Kings 2072 Ocean Avenue, Suit 102 Brooklyn NY 11230 718-376-2727504 Leonard Pace Physician New York Community Hospit YES 1639110620 172870 Kings 8119-7th Ave Brooklyn NY 11228 718-259-1444505 Ajoy Pandey Physician New York Community Hospit YES 1083694814 210671 Kings 2017 63rd Street Brooklyn NY 11204 718-234-3344506 Asha Pandey Physician New York Community Hospit YES 1841279031 218524-1 Kings 1302 New York Avenue Brooklyn NY 11203 718-703-9242507 Irina Pankova Physician New York Community Hospit YES 1023023777 209962 Kings 445 Kings Highway 1st fl. Brooklyn NY 11223 718-645-2201508 Adam Pass Physician New York Community Hospit YES 1184623803 182927 Kings 522 Bay Ridge Pkwy Brooklyn NY 11209 718-836-1779509 John Pawson Physician New York Community Hospit YES 1871564070 N005416 Kings 9229 Flatlands Avenue Brooklyn NY 11236 718-257-1444510 Charles Pearlman Physician New York Community Hospit YES 1902186802 188085 Kings 3632 Nostrand Avenue Brooklyn NY 11229 718-336-2259511 Richard Pellegrini Physician New York Community Hospit YES 1316912207 156967 Kings 2462 Flatbush Avenue Brooklyn NY 11234 718-253-2855512 Irene Perloff Physician New York Community Hospit YES 1982699773 216435 Kings 2626 East 14th St., Suite 204 Brooklyn NY 11235 718-517-2525513 Dmitri Petrychenko Physician New York Community Hospit YES 1588644272 227434 Kings 1660 E. 14th Street Suite 202 Brooklyn NY 11229 718-336-5123514 Boris Peysin Physician New York Community Hospit YES 1215028956 217884 Kings 8100 Bay Parkway, Suite 1M Brooklyn NY 11214 718-234-5100515 Manuel Pili Physician New York Community Hospit YES 1619927639 111503 Kings 1331 E. 19 Street Brooklyn NY 11230 718-998-3038516 Joseph Podhorzer Physician New York Community Hospit YES 1073515847 193410 Kings 445 Kings Highway 1st fl. Brooklyn NY 11223 718-645-2201517 Hitendra Rambhia Physician New York Community Hospit YES 1629061155 1934221 Kings 3131 Kings Highway, Suite O-3 Brooklyn NY 11234 718-377-7629518 Aleksandra Rayhker Physician New York Community Hospit YES 1437158151 207506 Kings 1400 Avenue Z, Suite 202 Brooklyn NY 11235 718-421-9070519 Mikhail Risman Physician New York Community Hospit YES 1407932239 158905 Kings 1021 Avenue Z Brooklyn NY 11235 718-769-7191520 Eric Rottenberg Physician New York Community Hospit YES 1871521278 219626 Kings 3041 Avenue U #2 Brooklyn NY 11229 718-692-0020






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

521 Mario Rottenberg Physician New York Community Hospit YES 1598793713 097895 Kings 3041 Avenue U #2 Brooklyn NY 11229 718-692-0020522 Anna Rozentul Physician New York Community Hospit YES 1790978955 250561 Kings 135 Sea Breeze Ave. Suite101 Brooklyn NY 11224 718-338-2957523 Aron Rubin Physician New York Community Hospit YES 1396788956 225667 Kings 500 Brightwater Ct. 4LB Brooklyn NY 11235 718-332-8064524 Asher Rudowsky Physician New York Community Hospit YES 1124323951 N006404 Kings 440 Avenue U Brooklyn NY 11223 718-627-8700525 Igor Ryndin Physician New York Community Hospit YES 1437172525 236385 Kings 1807 Avenue P Brooklyn NY 11229 718-676-1180526 Benzion Sacolick Physician New York Community Hospit YES 1508839317 153532 Kings 1227 Avenue Y Brooklyn NY 11235 718-382-6300527 Norman Saffra Physician New York Community Hospit YES 1811979735 179379 Kings 902 49th Street Brooklyn NY 11219 718-283-8000528 Salama Salama Physician New York Community Hospit YES 1073592226 203637 Kings 10 Plaza Street, Suite 1B Brooklyn NY 11238 718-638-2551529 Lawrence Santi Physician New York Community Hospit YES 1982676581 N002977 Kings 240 East 5 Street Brooklyn NY 11218 718-435-1031530 Javed Saqib Physician New York Community Hospit YES 1750321030 192826 Kings 693 Coney Island Avenue Brooklyn NY 11218 718-462-7315531 Patrick Sciortino Physician New York Community Hospit YES 1881613842 140141 Kings 914 Bay Ridge Parkway Brooklyn NY 11218 718-748-5700532 Michael Scotto Physician New York Community Hospit YES 1902974819 N005032A Kings 114 Terrace Place Brooklyn NY 11218 718-768-2768533 Nadezhda Shagumova Physician New York Community Hospit YES 1255309761 207429 Kings 2829 Ocean Parkway, 2nd Fl Brooklyn NY 11235 718-616-0050534 Swarna Shah Physician New York Community Hospit YES 1295884666 154777 Kings 739 Avenue Y Brooklyn NY 11235 718-891-6060535 Ravi Shanker Physician New York Community Hospit YES 181440986 197556 Kings 560 Bay Ridge Pkway Brooklyn NY 11209 718-238-1041536 Eugene Shapiro Physician New York Community Hospit YES 1518036698 N004180 Kings 301 Ocean View Ave. Brooklyn NY 11235 718-648-5001537 Alexander Shapsis Physician New York Community Hospit YES 1952325599 239090 Kings 2797 Ocean Pkwy. Brooklyn NY 11235 718-615-4000538 Jenny Shliozberg Physician New York Community Hospit YES 1174603971 170643 Kings 1321 E. 7th Street Brooklyn NY 11230 718-338-1313539 Jonathan Silver Physician New York Community Hospit YES 1891704268 195092 Kings 6900 4th Avenue Brooklyn NY 11209 718-238-6400540 Mohan Singhal Physician New York Community Hospit YES 1619189537 113802 Kings 3016 Glenwood Road Brooklyn NY 11210 718-434-3333541 Vladimir Smirnov Physician New York Community Hospit YES 1750302576 200156 Kings 135 Sea Breeze Ave., Suite 101 Brooklyn NY 11224 718-338-0300542 George Smith Physician New York Community Hospit YES 1205801982 204803 Kings 2066 Richmond Avenue. Brooklyn NY 10314 718-608-1111 [email protected] Sanjay Smith Physician New York Community Hospit YES 1548431315 243775 Kings 902 49th Street Brooklyn NY 11219 914-374-6684544 Norman Sobol Physician New York Community Hospit YES 1396752143 129360 Kings 3131 Kings Highway, C7 Brooklyn NY 11234 718-677-0009545 Inna Sominsky Physician New York Community Hospit YES 1649463522 226149 Kings 1660 E.14th Street Brooklyn NY 11229 718-382-8500546 Prabhat Soni Physician New York Community Hospit YES 1154376499 192569 Kings 2519 Avenue 'O' Brooklyn NY 11210 718-787-1900547 Gabriel Spergel Physician New York Community Hospit YES 1851396451 087865 Kings 1806 Ditmas Avenue Brooklyn NY 11226 718-853-3702548 Alan Stone Physician New York Community Hospit YES 1700867835 244253 Kings 2201 N. Central Exp. Suite 185 Brooklyn NY 75080 303-933-8270549 Mariya Stratilatova Physician New York Community Hospit YES 1750499448 235734 Kings 1725 E. 12th Street Brooklyn NY 11229 718-258-1727550 Joseph Stuto Physician New York Community Hospit YES 1689602344 N003993 Kings 100 Remsen St. Brooklyn NY 11201 718-624-7537551 Leonard Sudberg Physician New York Community Hospit YES 1710057815 146646 Kings 1590 East 19th Street Brooklyn NY 11230 718-375-7588552 Ira Tartack Physician New York Community Hospit YES 1669477311 N002391 Kings 2650 Ocean Parkway Brooklyn NY 11235 718-769-7800553 Sergey Terushkin Physician New York Community Hospit YES 1245424506 262892 Kings 150 Brighton 11 Street Brooklyn NY 11235 718-616-1622554 Larry Tetsoti Physician New York Community Hospit YES 1437104361 214196 Kings 1009 Brighton Beach Ave., 4th Fl Brooklyn NY 11235 718-336-6166555 Elie Traube Physician New York Community Hospit YES 1154589844 Kings 2270 Kimball Street, Suite 210 Brooklyn NY 11234 718-692-2700556 Mariya Tsinis Physician New York Community Hospit YES 1487673380 217276 Kings *8745 19 Avenue, Apt. 3F Brooklyn NY 11214 718-259-8116557 Tatyana Uvatov Physician New York Community Hospit YES 1568530848 N006193 Kings 3060 Ocean Avenue Brooklyn NY 11235 718-869-1098558 Dora Valdberg Physician New York Community Hospit YES 1023291820 N006233 Kings 3816 Nostrand Avenue Brooklyn NY 11235 347-713-6871559 Alina Vasilyeva Physician New York Community Hospit YES 1801861265 N006046 Kings 2116 Avenue P Brooklyn NY 11229 718-646-0131560 Mikhail Vaynblat Physician New York Community Hospit YES 1770695991 194914 Kings 4802 10th Avenue Brooklyn NY 11219 718-283-7688561 Zoya Vernikova Physician New York Community Hospit YES 1679664171 203457 Kings 2424 Kings Highway Brooklyn NY 11229 718-338-9660562 Inna Verzub Physician New York Community Hospit YES 1952354490 N006148 Kings 1075 Ocean Parkway Brooklyn NY 11230 718-676-0199563 Jerry Weinberg Physician New York Community Hospit YES 1306890785 219927 Kings 1215 Avenue M Brooklyn NY 11230 718-758-2010564 Jay Weissbluth Physician New York Community Hospit YES 1659376119 166454 Kings 3019 Avenue U Brooklyn NY 11229 718-934-1800565 Sanford Wert Physician New York Community Hospit YES 1477508661 128807 Kings 3075 Brighton 13 St. Brooklyn NY 11235 718-332-4747566 Daniel Wilen Physician New York Community Hospit YES 1033287628 184405 Kings 9202 Fort Hamilton Pkwy Brooklyn NY 11209 718-238-6518567 Richard Yan Physician New York Community Hospit YES 1306959812 161257 Kings 3131 Kings Highway, D-10 Brooklyn NY 11234 718-252-3590568 Leo Yankilevich Physician New York Community Hospit YES 1255355632 199964 Kings 2155A Ocean Avenue Brooklyn NY 11229 718-645-9236569 Joseph Yellin Physician New York Community Hospit YES 1700892783 140551 Kings 1599 East 15th Street Brooklyn NY 11230 718-377-2223570 Bernard Yonk Physician New York Community Hospit YES 1437224425 140237 Kings 2355 Ocean Avenue Brooklyn NY 11229 718-645-4291571 Igor Zakharov Physician New York Community Hospit YES 1043389539 228868 Kings 201 Kings Highway Brooklyn NY 11223 718-621-1811572 Nouriel Zalta Physician New York Community Hospit YES 1194921163 244539 Kings *1850 Ocean Parkway, #A-9 Brooklyn NY 11223 347-342-8640






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

573 Yury Zamdborg Physician New York Community Hospit YES 1932112158 197585 Kings 2005 Ocean Avenue Brooklyn NY 11230 718-375-8052574 Aleksandr Zasypkin Physician New York Community Hospit YES 1932244043 214413 Kings 2511 Ocean Ave, Suite 103 Brooklyn NY 11229 718-998-6161575 Lutheran Family Health Centers Lutheran Family Health Cent YES Kings Brooklyn NY576 Chan, Yuen Certified_Nurse_Midwife Brooklyn Chinese Family He YES 1497081962 03165895 001357 Kings 5008 - 7th Avenue Brooklyn NY 11220 Christine Tsai 718-210-1031577 Fu, Chung Wen Physician Brooklyn Chinese Family He YES 1306082730 03244680 257789 Kings 5008 - 7th Avenue Brooklyn NY 11220 Christine Tsai 718-210-1031578 Lee, Mary Ann Physician Brooklyn Chinese Family He YES 1104950047 01164218 135989 Kings 5008 - 7th Avenue Brooklyn NY 11220 Christine Tsai 718-210-1031579 Lee, Paul Physician Brooklyn Chinese Family He YES 1114091907 00659343 129364 Kings 5008 - 7th Avenue Brooklyn NY 11220 Christine Tsai 718-210-1031580 Lee, Wai-Kwan Physician Brooklyn Chinese Family He YES 1760421036 01089165 169992 Kings 5008 - 7th Avenue Brooklyn NY 11220 Christine Tsai 718-210-1031581 Li, Vuy San Physician Brooklyn Chinese Family He YES 1053331041 02674546 236280 Kings 5008 - 7th Avenue Brooklyn NY 11220 Christine Tsai 718-210-1031582 Ng, Angela Physician Brooklyn Chinese Family He YES 1265768394 03363164 255200 Kings 5008 - 7th Avenue Brooklyn NY 11220 Christine Tsai 718-210-1031583 Wong, Ying Lan Physician Brooklyn Chinese Family He YES 1396938130 02695650 229858 Kings 5008 - 7th Avenue Brooklyn NY 11220 Christine Tsai 718-210-1031584 Zhang, Ailing Physician Brooklyn Chinese Family He YES 1306079140 03276744 258321 Kings 5008 - 7th Avenue Brooklyn NY 11220 Christine Tsai 718-210-1031585 Zhao, Qiuqu Physician Brooklyn Chinese Family He YES 1750499901 02675230 236689 Kings 5008 - 7th Avenue Brooklyn NY 11220 Christine Tsai 718-210-1031586 Lee, Siu Kuen Dentist Brooklyn Chinese Family Hea YES 1437241908 02666017 50170 Kings 5008 - 7th Avenue Brooklyn NY 11220 Chih C. Chung 718-210-1030587 Sarkisian, Tatiana Dentist Brooklyn Chinese Family Hea YES 1881789857 02130298 48646 Kings 5008 - 7th Avenue Brooklyn NY 11220 Chih C. Chung 718-210-1030588 Chung, Chih C. Dentist Brooklyn Chinese Family Hea YES 1780772129 02860171 47433 Kings 5008 - 7th Avenue Brooklyn NY 11220 Chih C. Chung 718-210-1030589 Beecham-Robinson, Anita Physician Carribean American Family YES 1184700411 02585055 228070 Kings 3414 - Church Avenue Brooklyn NY 11203 Claudya Verdiner 718-630-4043590 Besson, Gail Physician Carribean American Family YES 1639287055 01884248 211088 Kings 3414 - Church Avenue Brooklyn NY 11203 Claudya Verdiner 718-630-4043591 Corbino, Laurene Certified_Nurse_Midwife Carribean American Family YES 1750493136 02175859 000960 Kings 3414 - Church Avenue Brooklyn NY 11203 Claudya Verdiner 718-630-4043592 Cotos-Mejia, David Physician Carribean American Family YES 1467452060 01685191 199253 Kings 3414 - Church Avenue Brooklyn NY 11203 Claudya Verdiner 718-630-4043593 Gyura, Philip Nurse_Practitioner Carribean American Family YES 1679915706 03809363 338490 Kings 3414 - Church Avenue Brooklyn NY 11203 Claudya Verdiner 718-630-4043594 Harrell, Linda Certified_Nurse_Midwife Carribean American Family YES 1689733404 02232277 000079 Kings 3414 - Church Avenue Brooklyn NY 11203 Claudya Verdiner 718-630-4043595 Joseph, Jonathan Physician Carribean American Family YES 1679531065 03473934 232310 Kings 3414 - Church Avenue Brooklyn NY 11203 Claudya Verdiner 718-630-4043596 Joseph, Shevon Physician Carribean American Family YES 1710140694 03024980 246793 Kings 3414 - Church Avenue Brooklyn NY 11203 Claudya Verdiner 718-630-4043597 Minus, Kelly Nurse_Practitioner Carribean American Family YES 1083922637 03302238 F336486 Kings 3414 - Church Avenue Brooklyn NY 11203 Claudya Verdiner 718-630-4043598 Saadon, Yael Nurse_Practitioner Carribean American Family YES 1245494897 03140769 381992 Kings 3414 - Church Avenue Brooklyn NY 11203 Claudya Verdiner 718-630-4043599 Ubanwa, Rosa Nurse_Practitioner Carribean American Family YES 1831409861 03337524 336512 Kings 3414 - Church Avenue Brooklyn NY 11203 Claudya Verdiner 718-630-4043600 Budhu, Peggy L. Dentist Carribean American Family H YES 1912072166 02545953 45878 Kings 3414 - Church Avenue Brooklyn NY 11203 Peggy L.Budhu 718-940-9425601 Grady, Laura Physician Family Physician Health Cent YES 1396856977 02225950 219244 Kings 5616 - 6th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837602 Lee, Wai-Kwan Physician Family Physician Health Cent YES 1760421036 01089165 169992 Kings 5616 - 6th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837603 Li, Vuy San Physician Family Physician Health Cent YES 1053331041 02674546 236280 Kings 5616 - 6th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837604 Lyon, Claudia Physician Family Physician Health Cent YES 1316054075 01294586 180938 Kings 5616 - 6th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837605 One, Sai Physician Family Physician Health Cent YES 1770756108 03247692 257764 Kings 5616 - 6th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837606 Pye, Yar Physician Family Physician Health Cent YES 1992767651 01783646 209836 Kings 5616 - 6th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837607 Rodriguez, Ariel Physician Family Physician Health Cent YES 1851344790 01761499 207034 Kings 5616 - 6th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837608 Shneyder, Tanya Physician Family Physician Health Cent YES 1942495346 03240053 251066 Kings 5616 - 6th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837609 Tin, Myint Physician Family Physician Health Cent YES 1063741809 03392174 262564 Kings 5616 - 6th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837610 Albdewi, Jamal Physician Park Ridge Family Health Ce YES 1023121704 01828046 210759 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837611 Bleich, Laurie Certified_Nurse_Midwife Park Ridge Family Health Ce YES 1194819896 02144961 000035 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837612 Faris, Basma Physician Park Ridge Family Health Ce YES 1073748448 03615529 262728 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837613 Islam, Noor Physician Park Ridge Family Health Ce YES 1801988613 01722201 203926 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837614 Joseph, Rose Nurse_Practitioner Park Ridge Family Health Ce YES 1619039138 02267518 380795 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837615 McAdam, John Physician Park Ridge Family Health Ce YES 1972547677 01183320 153881 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837616 Perlova, Marina Physician Park Ridge Family Health Ce YES 1598985418 01669324 203540 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837617 Prescott, Rasheda Physician Park Ridge Family Health Ce YES 1174685028 02842482 242324 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837618 Racines Bernstein, Donna Certified_Nurse_Midwife Park Ridge Family Health Ce YES 1013232040 03216548 F001369 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837619 Rimawi, Husam K Physician Park Ridge Family Health Ce YES 1063519304 00585855 142234 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837620 Rozentul, Anna Physician Park Ridge Family Health Ce YES 1790978955 03268628 250561 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837621 Sastre, Jorge Physician Park Ridge Family Health Ce YES 1780780742 02103900 218132 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837622 Thin, Cho Physician Park Ridge Family Health Ce YES 1134459597 03480848 265512 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837623 Abramowitz, Lauren Nurse_Practitioner Park Ridge Family Health Ce YES 1548670227 338478 Kings 6317 - 4th Avenue Brooklyn NY 11220 Ivan Cortes 718-630-6837624 Baptiste, Marjorie Dentist Park Ridge Family Health Cen YES 1255581674 03507348 55854 Kings 6317 - 4th Avenue Brooklyn NY 11220 Linda Kotmel 718-907-8100






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

625 Cucchiara, Gina Dentist Park Ridge Family Health Ce YES 1255610499 03423998 55681 Kings 6317 - 4th Avenue Brooklyn NY 11220 Linda Kotmel 718-907-8100626 Fainberg, Marina Dentist Park Ridge Family Health Ce YES 1174755193 03254359 54703 Kings 6317 - 4th Avenue Brooklyn NY 11220 Linda Kotmel 718-907-8100627 Haber, Sol Dentist Park Ridge Family Health Ce YES 1477695781 00715251 33220 Kings 6317 - 4th Avenue Brooklyn NY 11220 Linda Kotmel 718-907-8100628 Chandwani, Brijesh Dentist Park Ridge Family Health Ce YES 1447561485 03519500 56482 Kings 6317 - 4th Avenue Brooklyn NY 11220 Linda Kotmel 718-907-8100629 Hendler, Marc Dentist Park Ridge Family Health Ce YES 1306836010 00293976 31472 Kings 6317 - 4th Avenue Brooklyn NY 11220 Linda Kotmel 718-907-8100630 Merker-Eisen, Lara Dentist Park Ridge Family Health Ce YES 1508060732 03525091 53644 Kings 6317 - 4th Avenue Brooklyn NY 11220 Linda Kotmel 718-907-8100631 Rosenbach, Dale Dentist Park Ridge Family Health Ce YES 1902044530 03127488 54285 Kings 6317 - 4th Avenue Brooklyn NY 11220 Linda Kotmel 718-907-8100632 Budhrani, Rishika Nurse_Practitioner Park Slope Family Health Ce YES 1831447143 03492064 337091 Kings 220 - 13th Street Brooklyn NY 11215 Charles Paturno 718-630-6827633 De La Cruz, Bianca Physician Park Slope Family Health Ce YES 1962723924 03634035 271312 Kings 220 - 13th Street Brooklyn NY 11215 Charles Paturno 718-630-6827634 Dladla, Nonkulie Physician Park Slope Family Health Ce YES 1083836894 03266502 237629 Kings 220 - 13th Street Brooklyn NY 11215 Charles Paturno 718-630-6827635 Fioribello, Virginia Certified_Nurse_Midwife Park Slope Family Health Ce YES 1578903530 03711286 001501 Kings 220 - 13th Street Brooklyn NY 11215 Charles Paturno 718-630-6827636 Kesavan, Meera Physician Park Slope Family Health Ce YES 1689841272 03032560 242127 Kings 220 - 13th Street Brooklyn NY 11215 Charles Paturno 718-630-6827637 Marecheau, Jacqueline Physician Park Slope Family Health Ce YES 1023083391 02686886 233726 Kings 220 - 13th Street Brooklyn NY 11215 Charles Paturno 718-630-6827638 Olkhina, Ekaterina Physician Park Slope Family Health Ce YES 1114258795 03505346 266876 Kings 220 - 13th Street Brooklyn NY 11215 Charles Paturno 718-630-6827639 Stibitz, Lisa Nurse_Practitioner Park Slope Family Health Ce YES 1528409976 03802164 338515 Kings 220 - 13th Street Brooklyn NY 11215 Charles Paturno 718-630-6827640 Tomsa, Anca Physician Park Slope Family Health Ce YES 1336203801 03779206 197011 Kings 220 - 13th Street Brooklyn NY 11215 Charles Paturno 718-630-6827641 Kotmel, Linda Dentist Park Slope Family Health Ce YES 1619075306 02310814 42758 Kings 220 - 13th Street Brooklyn NY 11215 Linda Kotmel 718.832.5980642 Patel,Dinesh Dentist Park Slope Family Health Ce YES 1912910662 00729479 36625 Kings 220 - 13th Street Brooklyn NY 11215 Linda Kotmel 718.832.5980643 Fridline, Danielle Dentist Park Slope Family Health Ce YES 1295964203 03292679 54938 Kings 220 - 13th Street Brooklyn NY 11215 Linda Kotmel 718.832.5980644 Allen, Josephine Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1104951524 03107531 380808 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608645 Arbolino, Sally Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1659406106 02091550 380187 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608646 Brenkler, Faina Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1710022397 02297083 380070 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608647 Cole, Tina Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1154760304 03743799 F338114 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608648 Coulter, Maura Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1184939993 03276395 F382116 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608649 Daisley, Sharon Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1891839080 03107944 380106 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608650 Emma, Patricia Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1669534988 03189140 360358 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608651 Glaser, Evelyn Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1558687731 03222873 F382104 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608652 Lee, Mary Ann Physician SCHOOL HEALTH PROGRAM YES 1104950047 01164218 FL1429100 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608653 Levi, Linda Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1528142056 02267985 380169 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608654 Martinez, Carmen Physician SCHOOL HEALTH PROGRAM YES 1851474597 02267994 148325 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608655 Michaud, Valerie Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1457598005 01912087 F335468 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608656 Senatore, Claudia Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1184930406 03276780 F380791 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608657 Silver, Chvette Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1811031354 03108183 381640 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608658 Wilson, Alejandra Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1427210640 03330449 381990 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608659 Young, Anne Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1588708440 02297065 380413 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608660 Barra, Kimberly Physicians Assistant SCHOOL HEALTH PROGRAM YES 1164567103 002167 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608661 Guerrier, Roline Physicians Assistant SCHOOL HEALTH PROGRAM YES 1215958640 006896 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608662 Major, Rosemarie Physicians Assistant SCHOOL HEALTH PROGRAM YES 1730190778 04923 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608663 Vargas, Jessica Nurse_Practitioner SCHOOL HEALTH PROGRAM YES 1255675666 337679 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Luz Villamil-Bayonna 718-630-7608664 Gargano, Lynn Dentist School Health Program- Den YES 1912988197 02224257 42977 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Lynn Gargano 718-630-8526665 Kohli, Sonia Dentist School Health Program- Den YES 1295808988 01979400 48421 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Lynn Gargano 718-630-8526666 Toth- Gosk, Agnieszka Dentist School Health Program- Den YES 1326264086 03362452 53843 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Lynn Gargano 718-630-8526667 Brown, Untray Dentist School Health Program- Den YES 1841214087 01704787 46243 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Lynn Gargano 718-630-8526668 Felicetti, Dawn Marie Dentist School Health Program- Den YES 1598038440 02007005 48223 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Lynn Gargano 718-630-8526669 Seo, Sara Dentist School Health Program- Den YES 1124250162 03155915 54536 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Lynn Gargano 718-630-8526670 Tong, Helen H. Dentist School Health Program- Den YES 1487791935 03707522 53380 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Lynn Gargano 718-630-8526671 Uzoaru, Genevieve Dentist School Health Program- Den YES 1720198559 02698997 51961 Kings 5800 - 3rd Avenue Brooklyn NY 11220 Lynn Gargano 718-630-8526672 Aglialoro, George Physician Shore Road Family Practice YES 1770506727 01818184 208966 Kings 9000 Shore Road Brooklyn NY 11209 Charles Paturno 718-630-6827673 Kesavan, Meera Physician Shore Road Family Practice YES 1689841272 03032560 242127 Kings 9000 Shore Road Brooklyn NY 11209 Charles Paturno 718-630-6827674 Lasko, Lauren Nurse_Practitioner Shore Road Family Practice YES 1669711461 03551728 337796 Kings 9000 Shore Road Brooklyn NY 11209 Charles Paturno 718-630-6827675 Martingano, Francis Physician Shore Road Family Practice YES 1659304491 01710172 176133 Kings 9000 Shore Road Brooklyn NY 11209 Charles Paturno 718-630-6827676 Rodriguez, Ariel Physician Shore Road Family Practice YES 1851344790 01761499 207034 Kings 9000 Shore Road Brooklyn NY 11209 Charles Paturno 718-630-6827






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

677 Ryncarz, Ernesto, Wojciech Physician Shore Road Family Practice YES 1144511684 03652646 Kings 9000 Shore Road Brooklyn NY 11209 Charles Paturno 718-630-6827678 Tavrovskaya, Polina Physician Shore Road Family Practice YES 1437358934 02900145 245131 Kings 9000 Shore Road Brooklyn NY 11209 Charles Paturno 718-630-6827679 Adhia, Rajesh Dentist Sunset Park Family Health C YES 1487833877 02952798 53677 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875680 Albano, John Dentist Sunset Park Family Health C YES 1548389349 02545926 45407 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875681 Alterman, Yuliya Dentist Sunset Park Family Health C YES 1588943351 03381808 55567 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875682 Azzaretti, Charles Dentist Sunset Park Family Health C YES 1083808588 00956652 36579 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875683 Bina, Babak Dentist Sunset Park Family Health C YES 1871672758 02224142 47743 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875684 Bryant, Ronald Dentist Sunset Park Family Health C YES 1306937719 02545339 28357 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875685 Burns, Jeffrey Dentist Sunset Park Family Health C YES 1659361624 00301395 30124 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875686 Celona, John Dentist Sunset Park Family Health C YES 1487868881 02545875 44511 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875687 Cernigliaro, Julie Dentist Sunset Park Family Health C YES 1174621734 02666080 43889 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875688 DiMango, Anthony Dentist Sunset Park Family Health C YES 1215035712 02298451 19877 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875689 Elmaria, Asmaa Dentist Sunset Park Family Health C YES 1003810359 00674286 32723 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875690 Goldberger, Robert Dentist Sunset Park Family Health C YES 1487662870 02318270 34706 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875691 Green, Larry Dentist Sunset Park Family Health C YES 1245325190 02545366 29704 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875692 Harris, Bethany Dentist Sunset Park Family Health C YES 1831478601 03390732 55632 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875693 Hernandez, Susan Dentist Sunset Park Family Health C YES 1104039981 03129311 53472 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875694 Hyacinthe, Laurence Dentist Sunset Park Family Health C YES 1346438561 03275569 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875695 Kunin, Marc Dentist Sunset Park Family Health C YES 1013015643 02545691 40386 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875696 McEntee, Frances M Dentist Sunset Park Family Health C YES 1639225733 01826044 41431 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875697 Mejia, Aneta Dentist Sunset Park Family Health C YES 1891992541 02691803 51470 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875698 Mudgil, Vanita Dentist Sunset Park Family Health C YES 1902955693 03466108 49467 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875699 Olsen, David Dentist Sunset Park Family Health C YES 1902003452 002943335 24596 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875700 Ottenio, Barbara Dentist Sunset Park Family Health C YES 1073621371 02546096 48660 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875701 Pavlakos, Constantine Dentist Sunset Park Family Health C YES 1245359066 02545797 42784 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875702 Ramos-Rodriguez, Calix Dentist Sunset Park Family Health C YES 1598850554 02956045 48673 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875703 Rodriguez, James Dentist Sunset Park Family Health C YES 1811082613 02017123 41948 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875704 Rosenberg, Linda Dentist Sunset Park Family Health C YES 1134329568 01968294 32091 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875705 Shirakura, Akihiko Dentist Sunset Park Family Health C YES 1225136195 02882442 51741 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875706 Siegelman, Louis Dentist Sunset Park Family Health C YES 1194822569 00770585 35940 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875707 Sole, Michael Dentist Sunset Park Family Health C YES 1427277516 00351588 23874 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875708 Suarez, Omar Dentist Sunset Park Family Health C YES 1891869814 03170692 42834 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875709 Vuong, Anthony Dentist Sunset Park Family Health C YES 1891912002 01284293 43589 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875710 Weseley,Paul Dentist Sunset Park Family Health C YES 1255356325 02380894 28741 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875711 Wong, Diane Dentist Sunset Park Family Health C YES 1114012135 02844888 46946 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875712 Zats, Boris Dentist Sunset Park Family Health C YES 1134147770 02549851 49375 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875713 Bowe, Robert B. Dentist Sunset Park Family Health C YES 1154670057 03522332 54361 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875714 Jerrold, Laurance E. Dentist Sunset Park Family Health C YES 10436341772 00387040 32081 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875715 Kamen, Jonathan Dentist Sunset Park Family Health C YES 1467527572 03510845 29633 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875716 Layvey, Ann Dentist Sunset Park Family Health C YES 1356652408 03437189 55961 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875717 Shtivelman, Fatina Dentist Sunset Park Family Health C YES 1083842223 03707540 54935 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875718 St. James, Stephen Dentist Sunset Park Family Health C YES 1669408134 03520532 52568 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875719 Uglialoro, Lisa Dentist Sunset Park Family Health C YES 1790949931 PENDING 53897 Kings 150 - 55th Street Brooklyn NY 11220 James Rodriguez 718-630-6875720 Alcantara, Teodorico Physician Sunset Park Family Health Ce YES 1255359030 01888119 181740 Kings 150 - 55th Street Brooklyn NY 11220 AnneMarie Sabella 718-630-6830721 El Atat, Ali Physician Sunset Park Family Health Ce YES 1487853008 03063756 002651 Kings 150 - 55th Street Brooklyn NY 11220 AnneMarie Sabella 718-630-6830722 Filipova, Olga Physician Sunset Park Family Health Ce YES 1164588554 01888119 242587 Kings 150 - 55th Street Brooklyn NY 11220 AnneMarie Sabella 718-630-6830723 Kohn, Barry Physician Sunset Park Family Health Ce YES 1497941181 03482111 149344 Kings 150 - 55th Street Brooklyn NY 11220 AnneMarie Sabella 718-630-6830724 Leff, John Physician Sunset Park Family Health Ce YES 1689693327 01029065 143472 Kings 150 - 55th Street Brooklyn NY 11220 AnneMarie Sabella 718-630-6830725 Moussa, Marwa Physician Sunset Park Family Health Ce YES 1972807600 03384943 262886 Kings 150 - 55th Street Brooklyn NY 11220 AnneMarie Sabella 718-630-6830726 Olkhina, Ekaterina Physician Sunset Park Family Health Ce YES 1114258795 03505346 266876 Kings 150 - 55th Street Brooklyn NY 11220 AnneMarie Sabella 718-630-6830727 Oo, Mya Physician Sunset Park Family Health Ce YES 1801151337 03489723 265727 Kings 150 - 55th Street Brooklyn NY 11220 AnneMarie Sabella 718-630-6830728 Wagley, Bhupendra Physician Sunset Park Family Health Ce YES 1376551333 01211292 137686 Kings 150 - 55th Street Brooklyn NY 11220 AnneMarie Sabella 718-630-6830

269172






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

729 Zedan, Dena Physician Sunset Park Family Health Ce YES 1144552894 03505355 266964 Kings 150 - 55th Street Brooklyn NY 11220 AnneMarie Sabella 718-630-6830730 Amar, Amal Certified_Nurse_Midwife Sunset Park Family Health C YES 1578885356 03216731 001376 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042731 Barnes, Ila Nurse_Practitioner Sunset Park Family Health C YES 1144389685 03395026 420207 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042732 Cohen, Leslie Certified_Nurse_Midwife Sunset Park Family Health C YES 1912926262 02875249 001138 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042733 Milshteyn, Yuliya Certified_Nurse_Midwife Sunset Park Family Health C YES 1487649901 02521442 001079 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042734 Rodriguez, Ariel Physician Sunset Park Family Health C YES 1851344790 01761499 207034 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042735 Rodriguez-Dumont Physician Sunset Park Family Health C YES 1194985697 03569091 263456 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042736 Ryncarz, Ernesto, Wojciech Physician Sunset Park Family Health C YES 1144511684 03652646 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042737 Saadon, Yael Nurse_Practitioner Sunset Park Family Health C YES 1245494897 03140769 381992 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042738 Sheth, Aarti Physician Sunset Park Family Health C YES 1083840516 03302316 247651 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042739 Slattery, Carolyn Certified_Nurse_Midwife Sunset Park Family Health C YES 1629218664 03100447 001325 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042740 Taylor-Smalls, Sharon Certified_Nurse_Midwife Sunset Park Family Health C YES 1689740425 02912765 001230 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042741 Villanueva, Norma Physician Sunset Park Family Health C YES 1558384107 01601032 168961 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042742 Walker, Dionne Nurse_Practitioner Sunset Park Family Health C YES 1891112611 03822924 382328 Kings 5610 -2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042743 Yazigi, Samar Physician Sunset Park Family Health C YES 1780771345 02097583 217970 Kings 5610 - 2nd Avenue Brooklyn NY 11220 Claudette Richardson 718-630-6042744 Garankina, Olga Physician Sunset Terrace Family Healt YES 1558524207 03648744 250690 Kings 514 - 49th Street Brooklyn NY 11220 Evelyn Lopez 718-630-2251745 Murray, Christine Nurse_Practitioner Sunset Terrace Family Healt YES 1861677023 03188896 335135 Kings 514 - 49th Street Brooklyn NY 11220 Evelyn Lopez 718-630-2251746 Nedunchezian, Deeptha Physician Sunset Terrace Family Healt YES 1487674396 01473972 140066 Kings 514 - 49th Street Brooklyn NY 11220 Evelyn Lopez 718-630-2251747 Pollard-Thomas, Paula Physician Sunset Terrace Family Healt YES 1366518409 02269083 216906 Kings 514 - 49th Street Brooklyn NY 11220 Evelyn Lopez 718-630-2251748 Alvarado, Mark Physician Sunset Terrace Health Center YES 1821090663 03039925 229671 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636749 Belman, Lillian Physician Sunset Terrace Health Center YES 1730242611 02637130 234989 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636750 Bouchard-Burns, Jeffrey Physician Sunset Terrace Health Center YES 1326068537 02812962 239317 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636751 Cotton, Jordana Physician Sunset Terrace Health Center YES 1285833277 03218077 401147 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636752 Cuff-Carney, Diane Physician Sunset Terrace Health Center YES 1912129685 03151351 401009 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636753 Golden, Ann Nurse_Practitioner Sunset Terrace Health Center YES 1124180138 01935139 F400161 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636754 Olivier, Dalia Physician Sunset Terrace Health Center YES 1801081518 02946909 244307 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636755 Senosiain, Javier Physician Sunset Terrace Health Center YES 1396894549 02912018 235995 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636756 Serobyan, Yana Physician Sunset Terrace Health Center YES 1801997671 02296766 217571 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636757 Sirota, Elizabeth Physician Sunset Terrace Health Center YES 1255437125 02587180 231277 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636758 Torres, Felix Physician Sunset Terrace Health Center YES 1922138718 02964501 240257 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636759 Towey, Eldene Physician Sunset Terrace Health Center YES 1003065111 03567599 257211 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636760 Yu, Eric Physician Sunset Terrace Health Center YES 1093920241 03623163 257649 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636761 Ibrahim, Ihab Physician Sunset Terrace Health Center YES 1083876809 03776565 262429 Kings 514 - 49th Street Brooklyn NY 11220 Tomas Cruz 718-431-2636762 Kingsbrook Jewish Medical Center Community Physicians Kingsbrook Jewish Medical YES Kings Brooklyn NY763 Abayev, Zurab Physician Kingsbrook Jewish Medical YES 1841283058 2098548 215612 Kings 6414 Bay Parkway Brooklyn NY 11204 (718) 234-2300764 Abraham, Marthe Physician Kingsbrook Jewish Medical NO 1821056201 2144030 205003 Kings 255 Eastern Parkway Brooklyn NY 11238 (718) 636-8291765 Adam, Abdalla Physician Kingsbrook Jewish Medical YES 1295885374 2848786 241981 Kings 786 Saratoga avenue Brooklyn NY 11212 (718) 342-2500766 Adeonigbagbe, Olusegun Physician Kingsbrook Jewish Medical NO 1073570081 1624886 201260 Kings 192-03 Jamaica Avenue Hollis NY 11423 (718) 217-7744767 Afflu, Ernest Physician Kingsbrook Jewish Medical NO 1447294764 1801165 194932 Kings 1336 Utica Ave Brooklyn NY 11203 (718) 756-0918768 Agrawal, Arun Physician Kingsbrook Jewish Medical NO 1467455048 998701 159622 Kings 33 Front Street Hempstead NY 11550 (516) 565-4789769 Ahmad, Imtiaz Physician Kingsbrook Jewish Medical NO 1265509988 2819405 239419 Kings 731 coneyIsland Ave Brooklyn NY 11218 (718) 693-7777770 Ahmad, Syed Physician Kingsbrook Jewish Medical NO 1508898289 900587 163156 Kings 1473 Sterling Place Brooklyn NY 11213 (718) 756-3939771 Ahmed, Mostaque Physician Kingsbrook Jewish Medical NO 1003851064 1780414 219207 Kings 3309 Church Avenue Brooklyn NY 11203 (718) 856-3600772 Ahmed, Zia Physician Kingsbrook Jewish Medical NO 1083659239 1566976 192853 Kings 2146 Beverly Road Brooklyn NY 11226 (718) 469-6600773 Alexander, Caroline Physician Kingsbrook Jewish Medical YES 1083866875 3130747 253774 Kings 88- 49 163rd Street Jamaica NY 11432 (718) 658-2787774 Ali, Akhtar Physician Kingsbrook Jewish Medical NO 1659400679 10817789 206663 Kings EZ Care Medical Services Woodhaven NY 11421 (718) 850-0550775 Ali, Faisal Physician Kingsbrook Jewish Medical NO 1952520017 3285903 237530 Kings776 Amin, Deepak Physician Kingsbrook Jewish Medical NO 1659372829 1391726 189494 Kings 745 Nostrand Avenue Brooklyn NY 11216 (718) 735-6700777 Amini, Manouchehr Physician Kingsbrook Jewish Medical NO 1659465359 210086 114689 Kings 121 DeKalb Avenue Brooklyn NY 11201 (718) 250-8751778 Ancion, Jean Physician Kingsbrook Jewish Medical NO 1265609127 3054428 245310 Kings 1368 Nostrand Avenue Brooklyn NY 11226 (718) 693-2338779 Anglade, Albert Physician Kingsbrook Jewish Medical NO 1356414122 1883027 209796 Kings 1515 Church Avenue Brooklyn NY 11226 (718) 703-4968780 Anwar, Arshad Physician Kingsbrook Jewish Medical YES 1174635916 2069863 213294 Kings 795 Coney Island Ave 1 Brooklyn NY 11218 (718) 287-1811

269172






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

781 Appel, Rona Physician Kingsbrook Jewish Medical YES 1245291160 948256 146524 Kings 528 Neptune Avenue Brooklyn NY 11224 (718) 996-2020782 Aquino, Nicolas Physician Kingsbrook Jewish Medical YES 1811228703 3292091 266570 Kings 1140 Eastern Parkway Brooklyn NY 11213 (718) 483-8555783 Augustin, Wisly Physician Kingsbrook Jewish Medical NO 1902917487 2839325 235739 Kings 474 Midwood Street Brooklyn NY 11225 (718) 484-7373784 Avezbadalov, Uriel Physician Kingsbrook Jewish Medical YES 1235311010 2974550 246250 Kings785 Avraham, Isaia Physician Kingsbrook Jewish Medical NO 1043217185 1582943 188449 Kings 433 Mayfair Drive South Brooklyn NY 11234 (718) 209-5127786 Awuah, Kwame Physicians Assistant Kingsbrook Jewish Medical NO 1356486914 3138176 9643 Kings Bedford Stuyvesant Family Health CenterBrooklyn NY 11216 (718) 636-4500787 Badero, Oluyemi Physician Kingsbrook Jewish Medical YES 1598877839 1717266 190052 Kings 1932 Rockaway Parkway Brooklyn NY 11236 (718) 209-8000788 Bassily, Samir Physician Kingsbrook Jewish Medical NO 1619012663 2227118 219883 Kings789 Belamy, Jacquelin Physician Kingsbrook Jewish Medical YES 1609945815 1916009 204828 Kings 9613 Flatlands Avenue Brooklyn NY 11236 (718) 927-1355790 Benoit, Marcel Physician Kingsbrook Jewish Medical NO 1609855725 1582594 191242 Kings 1681 Flatbush Avenue Brooklyn NY 11210 (718) 338-4293791 Berg, Peter Physician Kingsbrook Jewish Medical NO 1780621730 1076439 154150 Kings 11 Plaza Street West Brooklyn NY 11217 (718) 638-2020792 Bhambhani, Ghanshyam Physician Kingsbrook Jewish Medical YES 1972565562 1947117 204823 Kings 107-06 Liberty Avenue Ozone Park NY 11417 (718) 323-2229793 Bhandari, Rekha Physician Kingsbrook Jewish Medical NO 1023035466 2134467 218001 Kings 385 Seneca Avenue Ridgewood NY 11385 (718) 821-1222794 Bhat, Premila Physician Kingsbrook Jewish Medical NO 1083818546 2886928 230740 Kings 65-19 Borden Avenue Maspeth NY 11378 (718) 899-0060795 Bhayani, Rajendra Physician Kingsbrook Jewish Medical NO 1467491423 2608428 226427 Kings 1783 West 6th Street Brooklyn NY 11223 (718) 249-9383796 Black, Andrew Physician Kingsbrook Jewish Medical YES 1669550687 669690 143801 Kings 907 St. Marks Avenue Brooklyn NY 11213 (718) 756-6200797 Blackett-Bonnett, Terry-Jan Physician Kingsbrook Jewish Medical YES 1568689099 1988696 213623 Kings 1641 Bergen Street Brooklyn NY 11213 (718) 778-2938798 Bonhomme, Wilner Physician Kingsbrook Jewish Medical YES 1215021514 1433518 190471 Kings 1220 East New York Avenue Brooklyn NY 11212 (718) 230-3345799 Borer, Jeffrey Physician Kingsbrook Jewish Medical NO 1609963792 572110 112183 Kings 635 Madison Avenue New York NY 10022 (212) 289-7777800 Borra, Sonia Physician Kingsbrook Jewish Medical NO 1871541508 275801 111163 Kings 3915 Avenue V Brooklyn NY 11234 (718) 252-8440801 Brecher, Rubin Physician Kingsbrook Jewish Medical NO 1609842749 1168941 165798 Kings 736 Ocean Parkway Brooklyn NY 11230 (718) 851-1186802 Browning, Jared Physician Kingsbrook Jewish Medical NO 1720174238 244292 Kings 11995 Singltree Lane Suite500 Eden Prairie MN 55344 (952) 595-1100803 Brutus, Pierre Physician Kingsbrook Jewish Medical YES 1841233046 235878 126426 Kings 716 Linden Boulevard Brooklyn NY 11203 (718) 693-2686804 Budzikowski, Adam Physician Kingsbrook Jewish Medical NO 1790725125 2650493 219902 Kings 450 Clarkson Road Brooklyn NY 11203 (718) 270-4147805 Burshteyn, Ilya Physician Kingsbrook Jewish Medical NO 1073546131 1996698 215638 Kings806 Capoor, Jaishree Physician Kingsbrook Jewish Medical NO 1063455202 2230188 A215693 Kings 94-25 59th Avenue Elmhurst NY 11373807 Carpio, Orlando Physician Kingsbrook Jewish Medical NO 1710978481 1157235 179699 Kings 4 Stults Drive Plainsboro NJ 8536 (609) 936-8738808 Casimir, Carl Physician Kingsbrook Jewish Medical NO 1710068721 2242946 223395 Kings 432 Linden Boulevard Brooklyn NY 11203 (718) 941-8505809 Castillo, Lourdes Physician Kingsbrook Jewish Medical NO 1902851629 943568 164898 Kings 585 Schenectady Avenue Brooklyn NY 11203 (718) 604-5292810 Cavusoglu, Erdal Physician Kingsbrook Jewish Medical NO 1417941683 1989826 185754 Kings 450 Clarkson Avenue Brooklyn NY 11203 (718) 270-7352811 Chafiian, Jonas Physician Kingsbrook Jewish Medical NO 1598824401 164232 97445 Kings 86 East 49th Street Brooklyn NY 11203 (718) 604-5452812 Chamani, Robert Physician Kingsbrook Jewish Medical NO 1952671786 3565771 6444 Kings813 Chandhoke, Davinder Physician Kingsbrook Jewish Medical NO 1639290760 1788967 184566 Kings 56-45 Main Street Flushing NY 11355 (718) 670-1374814 Chaskin, Daniel Physician Kingsbrook Jewish Medical NO 1578577979 865150 N003714-1 Kings 63-48 Forest Avenue Ridgewood NY 11385 (718) 417-4895815 Chaudhry, Mohammad Physician Kingsbrook Jewish Medical NO 1275602989 314856 132562 Kings 1 Brookdale Plaza Room 157 CHC Brooklyn NY 11212 (718) 240-6366816 Chaudhry, Mohammad Physician Kingsbrook Jewish Medical NO 1225074552 246240 126276-1 Kings 585 Schenectady Avenue Brooklyn NY 11203 (718) 604-5456817 Cheung, Chi Physician Kingsbrook Jewish Medical YES 1154305613 384996 121399 Kings 3080 Nostrand Avenue Brooklyn NY 11229 (718) 627-9080818 Chowdhury, A.S.M. Physician Kingsbrook Jewish Medical YES 1356418511 2593699 211248 Kings 1098 Liberty Avenue Brooklyn NY 11208 (718) 277-2700819 Chua, Michael Physician Kingsbrook Jewish Medical NO 1619931193 3291370 197798-1 Kings820 Cimafranca, Daniel Physician Kingsbrook Jewish Medical NO 1891877932 1113166 175189-1 Kings821 Cordero, Kenneth Physician Kingsbrook Jewish Medical NO 1588660583 2645063 234743 Kings822 Corley, Paul Physician Kingsbrook Jewish Medical NO 1366617763 1757693 174562 Kings One Cross Island Plaza Rosedale NY 11422 (718) 541-1449823 Custis, Kevin Physician Kingsbrook Jewish Medical NO 1811976970 1976654 211807 Kings 86 East 49th Street Brooklyn NY 11203 (718) 363-6675824 Daniel, Cary Physician Kingsbrook Jewish Medical NO 1114222502 3314183 251085 Kings 86 East 49th Street SuiteB Brooklyn NY 11203825 Demoz, Abraham Physician Kingsbrook Jewish Medical YES 1326110016 1712427 215203 Kings 9408 Flatlands Avenue Brooklyn NY 11236 (718) 272-0977826 Desgrottes, Schiller Physician Kingsbrook Jewish Medical NO 1528152840 774534 149506 Kings 387 Linden Boulevard Brooklyn NY 11203 (718) 462-7651827 Dessner, Eric Physician Kingsbrook Jewish Medical NO 1861686545 3047541 250306 Kings828 Dogra, Bupesh Physician Kingsbrook Jewish Medical NO 1275889743 265921 Kings829 Dolen, Suleyman Physician Kingsbrook Jewish Medical YES 1548225493 2205690 132824 Kings 89-06 135th Street Richmond Hill NY 11418 (718) 206-6708830 Dorman, Bruce Physician Kingsbrook Jewish Medical NO 1457353856 818933 N003551 Kings 61-34 188th Street Fresh Meadows NY 11365 (718) 454-4333831 Doyle, Belma Physician Kingsbrook Jewish Medical NO 1336342039 263931 Kings832 Dufresne, Alix Physician Kingsbrook Jewish Medical YES 1700819950 859485 157033 Kings 1166 Eastern parkway Brooklyn NY 11213 (718) 771-4987






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

833 Duggirala, Rudrama Physician Kingsbrook Jewish Medical YES 1891775425 1536456 D42056 Kings 90-45 Pitkin Avenue Ozone Park NY 11417 (347) 454-9152834 Duperval, Jacques Physician Kingsbrook Jewish Medical NO 1184681033 1476379 182104 Kings 60 Plaza Street East Brooklyn NY 11238 (718) 783-5168835 Edwards, Ayisha Physician Kingsbrook Jewish Medical NO 1346456340 3539824 2607541 Kings 1 Metrotech North Brooklyn NY 11201 (718) 564-2086836 Eisenstadt, Steven Physician Kingsbrook Jewish Medical NO 1285731570 64289400 155195 Kings 50 East 69th Street New York NY 10021 (212) 249-7775837 Eskandar, Antonious Physician Kingsbrook Jewish Medical NO 1982846911 N006541 Kings 9413 Flatlands Avenue Brooklyn NY 11236 (718) 649-6464838 Fahimuddin, Muhammad Physician Kingsbrook Jewish Medical NO 1316133770 2848759 242559 Kings 428 Graham Avenue Brooklyn NY 11211 (718) 383-3514839 Feit, Alan Physician Kingsbrook Jewish Medical NO 1245224716 483165 130244 Kings 450 Clarkson Avenue Brooklyn NY 11203 (718) 270-1568840 Felder, Kenneth Physician Kingsbrook Jewish Medical NO 1316910219 717208 131057 Kings 2035 Ralph Avenue Brooklyn NY 11239 (718) 209-0101841 Feygin, Marina Physician Kingsbrook Jewish Medical NO 1467495655 2081074 216924 Kings 2815 Ocean parkway, suite LI Brooklyn NY 11235 (718) 891-3005842 Feygis, Yuliya Physician Kingsbrook Jewish Medical NO 1871587089 2041638 211586 Kings 585 Schenectady Avenue Brooklyn NY 11212 (718) 604-5281843 Finkelstein, Seth Physician Kingsbrook Jewish Medical YES 1790754034 2828586 238454 Kings 950 Park Avenue New York NY 10028 (212) 472-8200844 Fishman, Henry Physician Kingsbrook Jewish Medical NO 1184707101 772023 154450 Kings 1602 E 17 Street Brooklyn NY 11238 (718) 376-6868845 Fisse, Richard Physician Kingsbrook Jewish Medical NO 1831275569 699752 134693 Kings 1353 49th Street Brooklyn NY 11219 (718) 854-8527846 Fleary, Milroy Physician Kingsbrook Jewish Medical NO 1821055682 2207909 213861 KingsKingsbrook Jewish Medical Center-Wound CareBrooklyn NY 11203 (718) 363-6541847 Francois, Jean Physician Kingsbrook Jewish Medical YES 1144209610 1655701 197329 Kings 1713 Ralph Avenue Brooklyn NY 11236 (718) 531-6100848 Francois, Pierre Physician Kingsbrook Jewish Medical NO 1184666109 926865 211072 Kings 11 Sandpiper Lane Centereach NY 11720 (718) 604-5070849 Freedman, Jeffrey Physician Kingsbrook Jewish Medical NO 1699758110 224222 119508 Kings 161 Atlantic Avenue Brooklyn NY 11201 (718) 596-9086850 Fried, Alvin Dentist Kingsbrook Jewish Medical NO 1912997297 1200215 35509 Kings Maimonides Medical Center - Dental DivisionBrooklyn NY 11219 (718) 283-7428851 Frost, David Physician Kingsbrook Jewish Medical NO 1669403044 680346 139242 Kings852 Gabriel, Guny Physician Kingsbrook Jewish Medical NO 1700907292 945208 161913-1 Kings 1718 Pitkin avenue Brooklyn NY 11212 (718) 485-9869853 Gasinu, Selom Physician Kingsbrook Jewish Medical NO 1154647725 262104 Kings854 Gebrezgi, Sebhatu Physician Kingsbrook Jewish Medical NO 1982750360 1545362 196278 Kings 9408 Flatlands Avenue Brooklyn NY 11236 (718) 272-0977855 Gelbfish, Gary Physician Kingsbrook Jewish Medical NO 1275508954 1161839 163406-1 Kings856 Gopal, Lekha Physician Kingsbrook Jewish Medical NO 1689624173 2063789 218774 Kings 218 Ridgedale Avenue Garwood NJ 7027 (973) 292-1113857 Greenstein, Yakov Physician Kingsbrook Jewish Medical NO 1144266206 1176329 160033 Kings858 Grosman, Igor Physician Kingsbrook Jewish Medical YES 1851506869 3100070 239458 Kings 1517 Voorhies Avenue Brooklyn NY 11235 (718) 332-0600859 Guagliano, Peter Dentist Kingsbrook Jewish Medical NO 1770506644 032538-1 Kings 355 Ovington Street suite 101 Brooklyn NY 11209 (718) 833-2880860 Gustave, Mario Physician Kingsbrook Jewish Medical NO 1184704736 3354294 232004 Kings 681 Clarkson Avenue Brooklyn NY 11203 (718) 221-7412861 Gutierrez, Omar Physician Kingsbrook Jewish Medical NO 1396998977 3197968 250840 Kings862 Guzman, Jeanette Physician Kingsbrook Jewish Medical NO 1407944895 3366290 52373 Kings863 Hameed, Rizwanullah Physician Kingsbrook Jewish Medical YES 1427008960 1580767 185935 Kings 86 East 49th Street Brooklyn NY 11203 (718) 604-5403864 Hanna, Raouf Physician Kingsbrook Jewish Medical NO 1235165200 1683283 201860-1 Kings865 Hariri, Enayatollah Physician Kingsbrook Jewish Medical NO 1376657247 224117 119476 Kings 2146 Beverly Road Brooklyn NY 11226 (718) 469-6600866 Hasan, Choudhury Physician Kingsbrook Jewish Medical NO 1780661009 1878124 193570 Kings 8405 169th Street Jamaica NY 11432 (718) 657-8001867 Hasan, Choudhury Physician Kingsbrook Jewish Medical NO 1629187752 1324794 187727 Kings 97-12 63rd Drive Flushing NY 11374868 Hasan, Muhammad Physician Kingsbrook Jewish Medical NO 1134170640 1428239 182626 Kings 481 St. Mark's Avenue Brooklyn NY 11238 (718) 638-8185869 Hasan, Shaikh Physician Kingsbrook Jewish Medical YES 1225020860 1919002 208519 Kings 501 McDonald Avenue #1A Brooklyn NY 11218 (718) 633-4677870 Hassan, Ferdausi Physician Kingsbrook Jewish Medical YES 1083728687 2358183 226178 Kings 37-43 76th street Jackson Heights NY 11372 (718) 779-8963871 Herrold, Edmund Physician Kingsbrook Jewish Medical NO 1649367731 893196 149191 Kings 450 Clarkson Avenue Brooklyn NY 11203 (718) 270-1568872 Hindi, Amjad Physician Kingsbrook Jewish Medical NO 261600 Kings Downstate Mental Health Association Brooklyn NY 11203 (718) 270-2728873 Hoskins, Jonathan Physician Kingsbrook Jewish Medical NO 1386993624 266877 Kings874 Hossain, Mohammed Physician Kingsbrook Jewish Medical NO 1972629368 2879358 242384 Kings 847 46th Street Brooklyn NY 11220 (718) 972-2347875 Hosten, David Physician Kingsbrook Jewish Medical NO 1194785634 751386 148247 Kings876 Htwe, Pwint Physician Kingsbrook Jewish Medical NO 1235391608 253489 253489 Kings 47 Plaza Street West Brooklyn NY 11217 (718) 789-4333877 Huh, Sam Physician Kingsbrook Jewish Medical NO 1386686293 1978101 201433 Kings DMRI Building - 3rd Floor - KJMC Brooklyn NY 11203 (718) 756-9025878 Ilyayev, Erik Physician Kingsbrook Jewish Medical YES 1891091484 3581913 265676 Kings 72-24 Kissena Blvd #14 Flushing NY 11367 (718) 576-4652879 Ilyayev, Rafael Physician Kingsbrook Jewish Medical YES 1730373192 29909539 245643-1 Kings880 Inker, Steven Physician Kingsbrook Jewish Medical NO 1992757231 1422673 180213 Kings 149 Jorelemon Street Brooklyn NY 11201 (718) 596-0204881 Isyanova, Ilvira Physician Kingsbrook Jewish Medical NO 1801167150 3480022 6443 Kings 665 Ocean Parkway Brooklyn NY 11230882 Iyer, Bhanu Physician Kingsbrook Jewish Medical NO 1730287269 2945366 2731 Kings 1423 Bedford Avenue Brooklyn NY 11216 (718) 773-0883883 Jacoby, Laurian Physician Kingsbrook Jewish Medical NO 1851327308 1043970 166878 Kings 2281 82nd Street Brooklyn NY 11214 (718) 621-0336884 Janardhanan, Thulasiram Physician Kingsbrook Jewish Medical NO 1104871680 1959517 220633 Kings






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

885 Janas, Nodar Physician Kingsbrook Jewish Medical NO 1770678021 2520721 226527 Kings 35-01 202 Street Bayside NY 11361 (718) 224-7194886 Jasty, Babu Physician Kingsbrook Jewish Medical YES 1326031535 579740 141049 Kings 240 Willoughby Street Brooklyn NY 11201 (718) 234-2300887 Jasty, Susmita Physician Kingsbrook Jewish Medical NO 1679529911 766069 153709 Kings 9413 Flatlands Ave. Brooklyn NY 11236 (718) 258-3712888 Jerome, Eric Physician Kingsbrook Jewish Medical YES 1841216330 87596 147460 Kings 1166 Eastern Parkway Brooklyn NY 11213 (718) 771-6133889 John, Sabu Physician Kingsbrook Jewish Medical NO 1386611531 2801178 217897 Kings 322 Linden Blvd Brooklyn NY 11226890 Johnson, Maurice Physician Kingsbrook Jewish Medical NO 1407973662 1430217 192925 Kings 618 Schenectady Avenue Brooklyn NY 11203 (718) 774-3950891 Jones, Caitlin Physician Kingsbrook Jewish Medical NO 1275686057 2420744 226487 Kings892 Jones, Otis Physician Kingsbrook Jewish Medical NO 1861563538 1724152 197850-1 Kings 836 New York Avenue Brooklyn NY 11203 (718) 856-1136893 Joseph, Alfred Dentist Kingsbrook Jewish Medical NO 1336143874 31092 Kings 311 Westervelt Avenue Staten Island NY 10301894 Joseph, Gardith Physician Kingsbrook Jewish Medical YES 1811928773 1928234 181857-1 Kings 391 Eastern Parkway Brooklyn NY 11216 (718) 928-7746895 Joseph, Rodrigue Physician Kingsbrook Jewish Medical YES 1841228236 2551893 196098 Kings 87-59 171 Street Jamaica NY 11432 (718) 523-2200896 Kahn-Kapp, Evelina Physician Kingsbrook Jewish Medical NO 1447214630 904825 160053-1 Kings897 Kalanadhabhatta, Vivekanand Physician Kingsbrook Jewish Medical NO 1295793263 1468051 182717 Kings 443 Linden Blvd Brooklyn NY 11203 (718) 736-3591898 Kamal, Mohammad Physician Kingsbrook Jewish Medical NO 1699834036 2008648 214302 Kings 79 Church Avenue Brooklyn NY 11218 (718) 431-0009899 Kantor, Diana Physician Kingsbrook Jewish Medical NO 1003047218 254314 Kings900 Karpenko, Oleg Physician Kingsbrook Jewish Medical NO 1770883415 3369064 N06391 Kings901 Katz, Victoria Physician Kingsbrook Jewish Medical NO 1508818212 2356774 225323 Kings 1664 East 14 Street Brooklyn NY 11229 (718) 375-2300902 Kaufman, Daniel Physician Kingsbrook Jewish Medical NO 1285867135 238761 Kings 2120 Ocean Avenue Brooklyn NY 11229 (718) 705-9025903 Kazeem, Saka Physician Kingsbrook Jewish Medical NO 1922057397 1379542 187740 Kings 1423 Bedford Avenue Brooklyn NY 11216 (718) 773-0883904 Khaham, Michael Physician Kingsbrook Jewish Medical NO 1790985596 3224297 246571 Kings 68 South Service Road Melville NY 11747 (516) 945-3000905 Khillan, Ratesh Physician Kingsbrook Jewish Medical NO 1588869374 3151842 266181 Kings 443 Linden Blvd Brooklyn NY 11203 (718) 282-6333906 Khoobyar, Neda Physician Kingsbrook Jewish Medical NO 1952355943 2362307 N005898 Kings 340 East 64th street New York NY 10065 (212) 679-3131907 Khusid, Maria Physician Kingsbrook Jewish Medical NO 1699814780 1841318 194062 Kings 5120 19th Avenue Brooklyn NY 11204 (718) 621-3413908 Kim, Kun-Kil Physician Kingsbrook Jewish Medical NO 1558356246 1550238 164749-1 Kings909 Kingsbrook Orthopedic Associates Kingsbrook Orthopedic Asso NO Kings 170 William Street New York NY 10038 (212) 312-5900910 Bryk, Eli Physician Kingsbrook Orthopedic Asso NO 1245204098 1026200 160873 Kings 170 William Street New York NY 10038911 Cerabona, Franco Physician Kingsbrook Orthopedic Asso NO 1073587978 999151 147290 Kings 170 William Street New York NY 10038 (212) 312-5922912 Issack, Paul Physician Kingsbrook Orthopedic Asso NO 1932305547 28923680 219508-1 Kings 170 William street New York NY 10038 (212) 312-5900913 Mollica, Peter Physician Kingsbrook Orthopedic Asso NO 1285683508 624502 N003105 Kings 8223 14th Avenue Brooklyn NY 11228 (718) 875-9357914 Phillips, Geoffrey Physician Kingsbrook Orthopedic Asso NO 1588706345 2128756 198456 Kings 170 William Street #4A New York NY 10038 (212) 604-6258915 Sands, Andrew Physician Kingsbrook Orthopedic Asso NO 1598730178 1523546 166721 Kings 170 William Street Manhattan NY 10038 (212) 312-5988916 Sharma, Atul Physician Kingsbrook Orthopedic Asso NO 1184693228 2968289 220698 Kings 170 William Street New York NY 10038 (646) 588-2526917 Slotwiner, Alexander Physician Kingsbrook Orthopedic Asso NO 1831309517 2896404 228032 Kings 170 william street Manhattan NY 10038 (212) 238-0125918 Webber, Geoffrey Physician Kingsbrook Orthopedic Asso NO 1699735027 2312729 219910 Kings 170 William Street Brooklyn NY 10038919 Kingsway Orthopedics Kingsway Orthopedics YES Kings 3156 Kings Highway Brooklyn NY 11234920 Senat, Eric Physician Kingsway Orthopedics NO 1316151525 1166106 173063 Kings 3156 Kings Highway Brooklyn NY 11234 (718) 252-7324921 Kinyon, Jeffrey Physician Individual NO 1326268871 243759 Kings922 Kirwin, Jon Physician Individual NO 1306940937 1557735 160062 Kings P.O. Box 3383 New York NY 10008 (718) 288-1875923 Kothuru, Ravi Physician Individual NO 1649227794 2362307 223921 Kings 94-13 Flatlands Ave. Brooklyn NY 11236 (718) 257-7770924 Kumar, Nanjundaiah Physician Individual YES 1093745556 2009561 188703 Kings 6273 woodhaven blvd Rego Park NY 11374 (718) 760-1100925 Kumthekar, Narendra Physician Individual NO 1598822116 2299567 224765 Kings 1700 Flatbush Avenue Brooklyn NY 11210 (718) 692-1120926 Lajeune, Jean Physician Individual NO 1053384081 2357880 227093 Kings 6300 8th Avenue Brooklyn NY 11220 (718) 283-8696927 Latif, Rabia Physician Individual NO 1053502732 2912352 268549 Kings928 Laudi, John Physician Individual NO 1447223532 1422673 229118 Kings 585 Schenectady Avenue Brooklyn NY 11203 (718) 604-5431929 Lavian, Emil Physician Individual NO 1811206147 3339562 6389 Kings 9413 Flatlands Avenue Brooklyn NY 11236 (718) 649-6464930 Lazar, Jason Physician Individual NO 1295729721 1493787 196413 Kings 450 Clarkson Avenue Brooklyn NY 11203 (718) 270-4147931 Lazow, Stewart Dentist Individual NO 1295701779 1319300 190291 Kings University Hospital of Brooklyn Brooklyn NY 11203 (718) 245-2987932 Lescouflair, Elisabeth Physician Individual NO 1043222060 1635501 195821 Kings 995 Green Place Baldwin NY 11510 (516) 223-6607933 Levendoglu, Hulya Physician Individual NO 1417995879 541626 1185 Kings 447 Alantic avenue Brooklyn NY 11217 (718) 797-8430934 Lewis, Shauna Physician Individual NO 1871563221 2560525 N005983-1 Kings 540 East 43rd Street Brooklyn NY 11203 (718) 451-1206935 Lota, Conrado Physician Individual NO 1629043963 1240853 162337 Kings 2554 Ridge Street Yorktown Heights NY 10598 (914) 962-6278936 Lowe, Steven Physician Individual YES 1619051612 2002197 212443 Kings






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

937 Lumibao, Ala-May Physician Individual YES 1356516462 3091105 249363 Kings938 Mackey, Oliver Physician Individual NO 1003811050 1130276 N004410 Kings 43-44 KIssen blvd Flushing NY 11355 (718) 445-7014939 Madeb, Isaac Physician Individual NO 1467452086 399913 122260 Kings 2241 Ocean Avenue Brooklyn NY 11229 (718) 375-3746940 Mahankali, Bhavani Physician Individual NO 1447208277 2259098 224539 Kings 23-14 College Point Blvd College Point NY 11356 (347) 312-3041941 Maini, Atul Physician Individual NO 1780876268 2965864 245574 Kings 23-14 college point College Point NY 11356 (347) 312-3041942 Malanum, Teofila Physician Individual YES 1053332999 238862 130479 Kings 595 Flatbush Avenue Brooklyn NY 11225 (718) 856-2800943 Malik, Abdul Physician Individual YES 1215923685 1298104 187398 Kings 608 Schenectady Ave. Brooklyn NY 11203 (718) 469-4006944 Malik, Asim Physician Individual NO 1518965086 773120 141998-1 Kings 1224 Eighth Avenue Brooklyn NY 11215 (718) 788-5588945 Mansukhani, Malti Physician Individual NO 1477716017 1058768 136241 Kings946 Manvar, Buddhadev Physician Individual YES 1629061833 709628 139432 Kings 64-14 Bay Parkway Brooklyn NY 11204 (718) 234-2300947 Markowitz, Avraham Physician Individual NO 1154321065 1423303 180939 Kings948 Marmur, Jonathan Physician Individual NO 1184619652 2339426 188907-1 Kings Division of Interventional Cardiology Brooklyn NY 11203 (718) 270-3273949 Martinez, Rogelio Physician Individual NO 1902047087 3099667 251377 Kings950 Matos, Adanela Physician Individual NO 1891728184 319553 134203 Kings951 McPherson, Philip Physician Individual NO 1336161132 1551000 191022-1 Kings952 Mehta, Kalpana Physician Individual NO 1942284690 1688435 200377 Kings 137 thorpe avenue Avenel NJ 7001 (718) 226-2330953 Mehta, Kusum Physician Individual NO 1215936489 218626 117675 Kings 151 East 49th Street Brooklyn NY 11203 (718) 756-3434954 Mehta, Sucharita Physician Individual NO 1942209176 2512572 230382 Kings 151 East 49th Street Brooklyn NY 11203 (718) 756-3434955 Mehta, Viplov Physician Individual NO 1760590236 1001653 164845 Kings 894 Eastern Parkway Brooklyn NY 11213 (718) 774-6060956 Milland, Thor Physician Individual NO 1679695258 3152518 254976 Kings957 Miller, Jeffrey Physician Individual NO 1811909393 2637369 N005987 Kings 5723 Avenue N Brooklyn NY 11234 (718) 968-3338958 Miller, John Physician Individual NO 1285788265 1027412 160105 Kings Long Island College Hospital Brooklyn NY 11201 (718) 780-1388959 Milman, Eduard Physician Individual NO 1134210636 1553355 196343 Kings 365 Mayfair Drive South Brooklyn NY 11234960 Milos, Jovan Physician Individual YES 1366423295 2134412 218660 Kings 66-38 Forest Avenue Ridgewood NY 11385 (718) 418-7681961 Modi, Jayaprakash Physician Individual NO 1679519946 342618 133287 Kings 894 Bard Avenue Staten Island NY 10301 (718) 727-9346962 Modi, Rajendra Physician Individual NO 1902895733 773280 154743 Kings 55-44 Metropolitan Avenue Ridgewood NY 11385 (718) 456-2020963 Moe, Khaing Physician Individual NO 1053388454 2157651 231211 Kings 385 Seneca Avenue Ridgewood NY 11385 (718) 821-1222964 Moise, Wesner Physician Individual NO 1528122314 228428 121660 Kings 363 Eastern Parkway Brooklyn NY 11216 (718) 773-2212965 Morgan, Daniel Physician Individual NO 1811064983 1957886 187322 Kings 3131 Kings Highway Brooklyn NY 11234 (718) 258-2588966 Moskovits, Manfred Physician Individual YES 1598705402 2574101 232323 Kings Maimonides Medical Center Brooklyn NY 11219 (917) 589-7172967 Mra, Zan Physician Individual NO 1710050497 246075 183223 Kings 1 Brookdale Plaza Brooklyn NY 11212 (718) 240-6366968 Mukherji, Rajat Physician Individual YES 1649229188 758301 140692 Kings 120 Boerum Place - Apt. 1A Brooklyn NY 11201 (718) 604-5592969 Muradov, Julia Physician Individual NO 1245476977 3096619 006289-1 Kings970 Nacier, Paul Physician Individual YES 1003873902 848875 144585 Kings 124 East 43rd Street Brooklyn NY 11203 (718) 940-6166971 NAPA NAPA NO Kings 68 South service Road Melville NY 11747972 Lee, Jay Physician NAPA NO 1740506104 3217109 256703 Kings 68 South service Road Melville NY 11747 (516) 945-3107973 Nasrullah, Habib Physician Nasrullah, Habib NO 1710925060 2395802 1760 Kings 3632 Nostrand Avenue Brooklyn NY 11201 (718) 332-4409974 Navedo Rivera, Maria Physician Navedo Rivera, Maria NO 1922028745 1500669 190946 Kings 90-01 A Roosevelt avenue 2nd FLoorJackson Heights NY 11372 (718) 205-4944975 Nazarian, Shahrzad Physician Nazarian, Shahrzad NO 1760522791 2440077 N005761 Kings 86 East 49th Street Suite D Brooklyn NY 11234 (718) 363-6690976 New York Heart and Medical PC New York Heart and Medical NO Kings977 Ahmad, Ijaz Physician New York Heart and Medical YES 1902895238 2701095 247775 Kings 47 Plaza Street west Brooklyn NY 11217 (646) 338-4912978 Dogar, Muhammad Physician New York Heart and Medical NO 1851312649 2518252 245651 Kings979 Iqbal, Pervaiz Physician New York Heart and Medical YES 1083658918 2512274 230198 Kings980 New York Radiology Alliance New York Radiology Alliance NO Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320981 Alam, Hamid Physician New York Radiology Alliance NO 1285659649 2784921 240456 Kings S & D Medical LLP Bedford Hills NY 10507 (914) 666-3320982 Balakhane, Edmond Physician New York Radiology Alliance NO 1992787121 2161099 203666 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320983 Bitter, Marsha Physician New York Radiology Alliance NO 1124000674 210295 146892 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320984 Brown, Lamont Physician New York Radiology Alliance NO 1619959327 2210837 212859 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320985 Campbell, Bruce Physician New York Radiology Alliance NO 1780666883 1749802 192141 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320986 Chang, Albert Physician New York Radiology Alliance NO 1083869226 3119257 252856 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320987 Denis, Reginald Physician New York Radiology Alliance NO 1699984682 2881276 243694-1 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-2220988 Dupont, Paul Physician New York Radiology Alliance NO 1639169527 197359-1 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

989 Herzog, Gary Physician New York Radiology Alliance NO 1518915941 1561953 186427 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320990 Hodges, Jason Physician New York Radiology Alliance NO 1306828744 2256866 223707 Kings S & D Medical LLP Bedford Hills NY 10507 (914) 666-3320991 Kronfeld, Gary Physician New York Radiology Alliance NO 1063526630 53190 152049-1 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-2220992 Leeds, Melvin Physician New York Radiology Alliance NO 1679556088 877963 109477 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320993 Limani, Robert Physician New York Radiology Alliance NO 1922011618 2051081 200410-1 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-2220994 Mandanas, Victor Physician New York Radiology Alliance NO 1356413785 2321497 220661 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320995 Robinson, Stephen Physician New York Radiology Alliance NO 1770566580 148921 92385 Kings 52 Main Street Bedford Hills NY 10506 (914) 666-3320996 Shrivastava, Abhishek Physician New York Radiology Alliance NO 1285842096 3113600 253589 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320997 Singh, Supreet Physician New York Radiology Alliance NO 1659530921 3119573 248530 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320998 Timm, Gregory Physician New York Radiology Alliance NO 1861450611 231404-1 Kings 52 Main street Bedford Hills NY 10507 (914) 666-2220999 Weinstein, Russell Physician New York Radiology Alliance NO 1992788459 2489027 224598 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-3320

1000 Wilkins, Robert Physician New York Radiology Alliance NO 1508840505 1167115 143114 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-33201001 Yang, Charles Physician New York Radiology Alliance NO 1679736706 3168870 243097 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-33201002 Niaz, Mohammad Physician Niaz, Mohammad NO 1376516500 1713657 193655-1 Kings 219-16 Linden Blvd Cambria Heights NY 114111003 Nir, Jacob Physician Nir, Jacob NO 1194787044 1634486 164222 Kings 3131 Kings Highway - Suite C11 Brooklyn NY 11234 (718) 253-98861004 Nischal, Sanjeev Physician Nischal, Sanjeev NO 1972609600 2810979 239532 Kings1005 Nord, Malik Physician Nord, Malik NO 1295992162 3294680 2588201 Kings1006 Ocean Family Care Center Ocean Family Care Center YES Kings 622 Ocean Avenue Brooklyn NY 112261007 Herard, Wilfrid Physician Ocean Family Care Center YES 1518924489 1450453 175218 Kings 622 Ocean Avenue Brooklyn NY 112261008 Jean-Francois, Theodore Physician Ocean Family Care Center YES 1871662379 783124 154993 Kings 622 Ocean Avenue Brooklyn NY 11226 (718) 693-28001009 Malhotra, Subhash Physician Ocean Family Care Center YES 1578576963 719071 139725 Kings 622 Schenectady Avenue Brooklyn NY 112031010 Okonkwo, Chinwe Physician Okonkwo, Chinwe YES 1023038890 1623665 200487 Kings 887 Rutland Road Brooklyn NY 11203 (718) 756-39181011 Orafidiya, Adebola Physician Orafidiya, Adebola YES 1831244227 1733531 203946 Kings 34 Plaza Street Brooklyn NY 11238 (718) 230-58851012 Osei-Kwakye Gynecology Osei-Kwakye Gynecology NO Kings1013 Kwakye-Berko, Frank Physician Osei-Kwakye Gynecology 1518043819 2107880 217255 Kings 249 Empire Blvd Brooklyn NY 11225 (718) 940-22291014 Osei, Solomon Physician Osei-Kwakye Gynecology NO 1598726085 2432337 227009 Kings 249 Empire Blvd Brooklyn NY 11225 (718) 940-22291015 Suntay, Berk Physician Osei-Kwakye Gynecology NO 1841429974 3732381 267998 Kings 249 Empire Blv d Brooklyn NY 112251016 Osei-Tutu, Achiamah Physician Osei-Tutu, Achiamah NO 1376733345 251302 Kings 84 Linden Blvd Brooklyn NY 11226 (718) 826-13551017 Osofisan, Olatunde Physician Osofisan, Olatunde NO 1306129341 3618760 N006467 Kings1018 Ostad, Abraham Physician Ostad, Abraham NO 1568476968 207112 113668 Kings 2508 Ocean Avenue Brooklyn NY 11229 (718) 258-18001019 Ovshaev, Samira Physician Ovshaev, Samira NO 1679518237 3251416 219865 Kings 4010 Ave J Brooklyn NY 11210 (718) 266-97791020 Pae, Robert Physician Pae, Robert NO 1427022896 2006811 214203 Kings 585 Schenectady Avenue Brooklyn NY 11203 (718) 604-54831021 Paganelli-D'Ambrosio, Silvia Physician Paganelli-D'Ambrosio, Silvia NO 1891808754 1101098159 164553 Kings 1452 East 98th Street Brooklyn NY 11236 (718) 531-00551022 Pandey, Ajoy Physician Pandey, Ajoy YES 1083694814 42C531 210671 Kings 2017 - 63rd Street Brooklyn NY 11204 (718) 234-33441023 Pardeshi, Ramsing Physician Pardeshi, Ramsing NO 1205895760 879158 157937 Kings 372 South Oyster Bay Road Hicksville NY 11801 (516) 822-16901024 Pascal, Akil Physician Pascal, Akil NO 1336300201 3546958 254101 Kings 546 Eastern Parkway Brooklyn NY 11225 (718) 826-59001025 Pasco, Neil Physician Pasco, Neil NO 1871762211 3026102 246714-1 Kings 1825 East Chester Road Bronx NY 10461 (718) 904-20001026 Patel, Harish Physician Patel, Harish NO 1396784534 1484862 178546 Kings 132 St. Nicholas Avenue Brooklyn NY 112371027 Patel, Himanshu Physician Patel, Himanshu YES 1962460352 985662 1685041 Kings 220A St. Nicholas Ave Brooklyn NY 11237 (718) 821-92621028 Patel, Jigar Physician Patel, Jigar NO 1235394412 3041238 249592 Kings 220 St Nicholas Avenue Brooklyn NY 11232 (718) 821-92621029 Patel, Jitendra Physician Patel, Jitendra NO 1669410775 785108 155137 Kings 34-20 Avenue N Brooklyn NY 11234 (718) 258-70191030 Patel, Ketan Physician Patel, Ketan NO 1386722825 3092606 250728 Kings1031 Patel, Miksha Physician Patel, Miksha NO 1295773307 1019992 167089 Kings 3420 Avenue N Brooklyn NY 11234 (718) 692-46331032 Patrice, Geoffroy Physician Patrice, Geoffroy NO 1063534741 766596 141929 Kings 914 East 84th Street Brooklyn NY 11236 (718) 241-46211033 Paul, Henry Physician Paul, Henry NO 1477507341 1749531 179494 Kings 86 E. 49th Street Brooklyn NY 11203 (718) 604-58881034 Paul, Joseph Physician Paul, Joseph YES 1558387431 1450586 179720 Kings 60 Plaza Street Brooklyn NY 11238 (718) 857-88741035 Paulino, Carl Physician Paulino, Carl NO 1881884468 240110 Kings 450 Clarkson Avenue Brooklyn NY 112031036 Pena, Jose Physician Pena, Jose NO 1124064357 2131804 218573 Kings 845 Cliffside Avenue Valley Stream NY 11581 (516) 837-90311037 Pennant, Ainsley Physician Pennant, Ainsley NO 1033174511 593279 145809 Kings 808 New York Avenue Brooklyn NY 11203 (718) 462-48821038 Perlstein, Seymour Physician Perlstein, Seymour NO 1497766547 3661103 135256 Kings 1842 50th Street Brooklyn NY 11204 (718) 436-63681039 Pervin, Afroz Physician Pervin, Afroz NO 1215127170 2897625 245333 Kings 97-12 63rd Drive Rego Park NY 11374 (718) 830-33881040 Petit, Leslie Nurse_Practitioner Petit, Leslie NO 1891075321 3419587 F336892 Kings






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1041 Peysin, Boris Physician Peysin, Boris NO 1215028956 20845296 217884 Kings 8100 Bay Parkway Brooklyn NY 11214 (917) 568-53901042 Pillalamarri, Eswar Physician Pillalamarri, Eswar NO 1740374222 344902 130961 Kings Department of Anesthesiology Brooklyn NY 11234 (718) 951-30731043 Pinkhasov, Aaron Physician Pinkhasov, Aaron NO 1962435032 2017202 225772-1 Kings 585 Schenectady Avenue Brooklyn NY 11203 (718) 604-50371044 Polepalle, Sapan Physician Polepalle, Sapan YES 1912954009 354114 239371-1 Kings 202 St. Nicolas avenue Brooklyn NY 11237 (347) 295-26001045 Post, Nicholas Physician Post, Nicholas NO 1467670992 2911948 225414 Kings 339 Hicks Street Brooklyn NY 11201 (718) 780-13881046 Prasad, Ankineedu Physician Prasad, Ankineedu NO 1942259205 2690471 199086-1 Kings 23-14 College Point Blvd. College Point NY 11356 (347) 312-30411047 Preet, Mohan Physician Preet, Mohan NO 1134243595 270060 Kings 443 Linden Blvd Brooklyn NY 11203 (718) 282-63331048 Preibisz, Jacek Physician Preibisz, Jacek NO 1003915745 1171553 164041 Kings 635 Madison Avenue 3rd Floor New York NY 10022 (212) 289-77771049 Purcell, Roland Physician Purcell, Roland NO 1073693594 968685 157204 Kings 83 East 38th Street Brooklyn NY 11203 (718) 778-33111050 Rabiei, Payman Physician Rabiei, Payman NO 1235159443 2142872 N005606-1 Kings 94-13 Flatlands Avenue Suite East 201 Brooklyn NY 11236 (718) 649-64641051 Rajpal, Sanjeev Physician Rajpal, Sanjeev NO 1780635797 711293 132687 Kings 9413 Flatlands Avenue Suite 203E Brooklyn NY 11236 (718) 251-12121052 Rambhia, Hitendra Physician Rambhia, Hitendra NO 1629061155 1441258 98-140 Kings 3131 Kings Highway Brooklyn NY 11234 (718) 377-76291053 Ramdas, Rabindranauth Physician Ramdas, Rabindranauth NO 1417073172 2087772 209459-1 Kings 222 Stations Plaza North Mineola NY 115011054 Ramdhaney, Susan Physician Ramdhaney, Susan NO 1134206345 2958730 242446-1 Kings 2211 Emmons Avenue Brooklyn NY 11235 (718) 368-29601055 Rau, Anjan Physician Rau, Anjan YES 1477504363 1816875 168069 Kings 330 9th Street Brooklyn NY 11215 (718) 832-19641056 Rauchwerger, Orna Physician Rauchwerger, Orna NO 1083676258 2617976 5888 Kings1057 Reddy, Chenna Physician Reddy, Chenna YES 1679640650 767753 121755 Kings 94-13 Flatlands Avenue Brooklyn NY 11236 (718) 257-66151058 Reddy, Lalitha Physician Reddy, Lalitha YES 1487754693 228735 151460 Kings 9417 Flatlands Avenue Brooklyn NY 11236 (718) 257-66151059 Reddy, Vidya Physician Reddy, Vidya NO 1609875533 2550489 231766 Kings 1834 Rockaway Parkway Brooklyn NY 11236 (718) 251-15151060 Rehman, Shafiq Physician Rehman, Shafiq NO 1750509675 3498280 242342 Kings1061 Reich, Raymond Physician Reich, Raymond YES 1578541652 226453 120675 Kings 118 West End Avenue Brooklyn NY 11235 (718) 332-62001062 Richards, Jonathan Physician Richards, Jonathan NO 1649594193 N006522 Kings 1390 Pennylvian Brooklyn NY 112391063 Romsaitong, Panus Physician Romsaitong, Panus NO 1801825096 194878 209009 Kings 9876 Queens Boulevard Rego Park NY 11374 (718) 896-52551064 Rotman, Marvin Physician Rotman, Marvin NO 1740268309 137393 87452 Kings 450 Clarkson Avenue, Box 1211 Brooklyn NY 11203 (718) 270-21811065 Rubano, Angelo Physician Rubano, Angelo YES 1649382607 246460 126664 Kings 585 Schenectady Ave Brooklyn NY 11203 (718) 604-54211066 Russo, Charles Physician Russo, Charles NO 1942264189 656079 NOO3120 Kings 481 St.Matks Avenue Brooklyn NY 112381067 Sacolick, Benzion Physician Sacolick, Benzion NO 1508839317 960687 153532 Kings 1227 Avenue Y brooklyn NY 11235 (718) 382-63001068 Sadaphal, Charles Physician Sadaphal, Charles NO 1649338930 892604 156265 Kings1069 Saha, Pamela Physician Saha, Pamela NO 224845 Kings 450 Clarkson Avenue Brooklyn NY 11203 (718) 270-27281070 Salciccioli, Louis Physician Salciccioli, Louis NO 1326033630 1113955 163907 Kings 450 Clarckson Avenue Box 1199 Brooklyn NY 11203 (718) 270-15681071 Samad, Majid Physician Samad, Majid NO 1720040280 2468275 214323 Kings 262 Mercury Street East Meadow NY 11554 (516) 572-68221072 Samra, Eliahu Physician Samra, Eliahu YES 1093785057 1282686 186240 Kings1073 Sandhu, Shiraz Physician Sandhu, Shiraz NO 1952566655 3423109 246230 Kings 894 Eastern Parkway Brooklyn NY 11213 (718) 774-60601074 Santi, Lawrence Physician Santi, Lawrence NO 1982676581 N002977-1 Kings 240 East 5th Street Brooklyn NY 11218 (718) 435-10311075 Santiago, Allan Physician Santiago, Allan YES 1235106527 2578081 250074 Kings 2091 Nostrand Avenue Brooklyn NY 112101076 Saqib, Javed Physician Saqib, Javed NO 1750321030 1553319 192826 Kings 693 Coney Island Avenue Brooklyn NY 11218 (718) 462-73151077 Sardar, Henry Physician Sardar, Henry YES 1427191618 2864455 242950-1 Kings1078 Sardo, Gulmira Physician Sardo, Gulmira YES 1104120690 3499685 265407 Kings 2665 East 23 Street Brooklyn NY 112351079 Saxena, Anil Physician Saxena, Anil NO 1841297504 248499 126828 Kings 1700 Flatbush Avenue Brooklyn NY 11210 (718) 951-64951080 Scarpidis, Ulysses Physician Scarpidis, Ulysses NO 1205004603 245842-1 Kings 315 West 57th Street New York NY 10019 (212) 884-04441081 Schneidermesser, Susan Physician Schneidermesser, Susan NO 1548330764 1387764 N004955 Kings 40 Prospect Park West Brooklyn NY 11215 (718) 398-75931082 Sealey - Dupree, Audrey Nurse_Practitioner Sealey - Dupree, Audrey NO 1669494464 212096 331680 Kings 451 Clarkson ave Brooklyn NY 11203 (718) 245-46861083 Seckin, Tamer Physician Seckin, Tamer NO 1164452827 943980 157705-1 Kings 872 Fifth Avenue New York NY 10065 (212) 988-14441084 Shahem, Daher Physician Shahem, Daher NO 1104822519 224199 Kings 654 84th Street Brooklyn NY 11228 (718) 921-59121085 Sharaby, Jacob Physician Sharaby, Jacob NO 1386619443 2006917 195122 Kings 770 Ocean Parkway Brooklyn NY 11230 (718) 941-20021086 Sheikh, Rukhsana Physician Sheikh, Rukhsana NO 1710195656 3785059 263269-1 Kings1087 Shein, Leon Physician Shein, Leon NO 1215004858 1164070 168451 Kings 1545 Atlantic Avenue Brooklyn NY 11213 (718) 613-44421088 Sher, Lawrence Physician Sher, Lawrence NO 1841308905 867038 140157 Kings 2414 Kings Highway Brooklyn NY 11229 (718) 421-23761089 Sherman, Steven Physician Sherman, Steven NO 1528159027 767780 135244 Kings 2303 Avenue Z Brooklyn NY 11235 (718) 934-66001090 Shpitalnik, Vilor Physician Shpitalnik, Vilor NO 1629094495 1497781 195295-1 Kings 1723 East 12th Street Brooklyn NY 11229 (718) 633-50041091 Shrivastava, Devendra Physician Shrivastava, Devendra NO 1952494536 1506849 182573 Kings Interfaith Medical Center Brooklyn NY 11213 (718) 613-44421092 Shukla, Meenal Physician Shukla, Meenal NO 1508806076 2691330 236773 Kings 585 Schenectady Avenue Brooklyn NY 11203 (718) 363-6874






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1093 Siddique, Mohammad Physician Siddique, Mohammad NO 1104951268 2060644 213150 Kings 170-20 84th Avenue Jamaica NY 11432 (718) 739-43431094 Simon, Herold Physician Simon, Herold YES 1427034974 1191588 175968 Kings 176 Fenimore Street Brooklyn NY 11225 (718) 940-04001095 Singh, Jai Physician Singh, Jai NO 1609890771 1345697 174901 Kings 1496 St. John's Place Brooklyn NY 11213 (718) 552-20211096 Sloane, Adam Physician Sloane, Adam NO 1699934430 3318458 TUV 007295 Kings1097 Smith, Clover Nurse_Practitioner Smith, Clover NO 1225041742 333634 Kings Long Island College Hospital Brooklyn NY 11209 (718) 780-10001098 Smith, Edward Physician Smith, Edward NO 1609813468 1132970 168677 Kings 34 Plaza Street East Brooklyn NY 11238 (718) 638-20201099 Song, Dajun Physician Song, Dajun NO 1902088602 2987740 247579 Kings 68 S service Road Melville NY 11747 (516) 945-30001100 Song, Xiaoyan Physician Song, Xiaoyan YES 1821368390 3547537 267041 Kings1101 Sotnik, Regina Physician Sotnik, Regina NO 1912952466 2094677 212528-1 Kings 2146 Beverly Road Brooklyn NY 11226 (718) 469-66001102 Srivastava, Sudhesh Physician Srivastava, Sudhesh YES 1396783999 2559662 220763 Kings 833 57th Street Brooklyn NY 11220 (718) 686-73001103 Stanchina, Joel Physician Stanchina, Joel NO 1669454161 775035 147373 Kings 3915 Avenue V Brooklyn NY 11234 (718) 252-84401104 Sudberg, Leonard Physician Sudberg, Leonard NO 1710057815 693792 146646 Kings 1590 East 19th Street Brooklyn NY 11230 (718) 375-75881105 Sumner, Jonathan Physician Sumner, Jonathan NO 1427030097 821018 145571 Kings 30 Hempstead Avenue Rockville Center NY 115661106 Supplice, Julien Physician Supplice, Julien NO 1104875616 1674559 98348 Kings 86 East 49th Street Brooklyn NY 11203 (718) 604-53651107 Szczepanski, Michael Physician Szczepanski, Michael NO 1407847627 2334123 N005777 Kings 7708 Fifth Avenue Brooklyn NY 11209 (718) 363-66711108 Tafler, Leonid Physician Tafler, Leonid NO 1932237146 1906270 212382 Kings 4010 Avenue J Brooklyn NY 11210 (718) 338-11661109 Taher, Abu Physician Taher, Abu NO 1457435737 1879092 211161 Kings 1602 Quentin Road Brooklyn NY 11229 (718) 339-89501110 Tan, Marco Physician Tan, Marco NO 1871703975 484937 253740-1 Kings1111 Tarnarider, Alex Physician Tarnarider, Alex NO 1598760241 1432411 5462 Kings 319 Brighton Beach Avenue Brooklyn NY 11235 (718) 616-16001112 Tawfik, Mary Physician Tawfik, Mary NO 1255357034 2041752 215284 Kings 2146 Beverly Road Brooklyn NY 11226 (718) 469-66011113 Tefera, Fekade Physician Tefera, Fekade NO 1336177328 1702978 224113 Kings 1222 East 96 Street Brooklyn NY 11236 (718) 874-70951114 Theogene, Fernand Physician Theogene, Fernand YES 1093771206 1847281 196985 Kings 224 New York Ave Brooklyn NY 11216 (718) 363-79541115 Torno, Maria Amor Physician Torno, Maria Amor NO 1114967536 1393323 167830 Kings1116 Tseyko, Olga Physician Tseyko, Olga NO 1275737686 2173595 221645-1 Kings1117 Tsilov, Ernest Physician Tsilov, Ernest NO 1821304080 3317764 6382 Kings1118 Tucci, James Physician Tucci, James YES 1477528107 941424 158863 Kings 585 Schenectady Avenue Brooklyn NY 11203 (718) 604-54811119 Berger, Julius Dentist University Dental Associates NO 1265422075 304370 24825 Kings Kings County Hospital Brooklyn NY 11203 (718) 245-22991120 Urphanishvili, Tinatin Physician Urphanishvili, Tinatin YES 1033359757 3375422 262250 Kings1121 Uter, Samuel Physician Uter, Samuel YES 1699713792 1842277 200231 Kings Pierre Toussaint Family Health Center Brooklyn NY 11213 (718) 221-35071122 Valbrun, Leon Physician Valbrun, Leon YES 1386686848 951900 163523 Kings1123 Valery, Emmanuel Physician Valery, Emmanuel YES 1750334157 1463432 181472-1 Kings 176 Fenimore Street Brooklyn NY 11225 (718) 940-04001124 Valladares, Glenn Physician Valladares, Glenn NO 1457384000 1873610 210148 Kings1125 Van Gronigen, Peter Physician Van Gronigen, Peter NO 1720159205 484937 133162-1 Kings1126 Vasudevan, Parvathy Physician Vasudevan, Parvathy NO 1235203654 1814259 179694 Kings 13 Turf Lane Roslyn Heights NY 11577 (516) 484-21601127 Virani, Akbarali Physician Virani, Akbarali NO 1437158300 403136 129369 Kings 35 Crest Hollow Lane Albertson NY 11507 (516) 625-19661128 Virtual Radiologic Professionals, LLC Virtual Radiologic Profession NO Kings 11995 Singletree Lane Eden Prairie MN 55344 (952) 595-11001129 Aikawa, Taro Physician Virtual Radiologic Profession NO 1144265455 227652 Kings 11995 SingleTree Lane Suite 500 Eden Prairie MN 55344 (952) 595-11001130 Bardini, John Physician Virtual Radiologic Profession NO 1780669986 238764 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-11001131 Bolkhovets, Dmitry Physician Virtual Radiologic Profession NO 1588636732 223385 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-11001132 Bulczak, Dariusz Physician Virtual Radiologic Profession NO 1124011044 220495 Kings 11995 Singletree Lane Eden Prairie MN 55343 (952) 595-11001133 Burkholz, Kimberly Physician Virtual Radiologic Profession NO 1417914169 243459 Kings 11995 SingleTree Lane suite 500 Eden Prairie MN 55344 (952) 595-11001134 Chang, John Physician Virtual Radiologic Profession NO 1720063852 234147 Kings 11995 Singletree Lane, suite500 Eden Prairie MN 55344 (952) 595-11001135 Delavallade, Dawn Physician Virtual Radiologic Profession NO 1750445086 244644 Kings 11995 Singletree Lane Eden Prairie MN 55344 (952) 595-11001136 Diaz-Horsley, Jannell Physician Virtual Radiologic Profession NO 1225039167 251491 Kings 11995 SIngletree Lane suite 500 Eden Prairie MN 55343 (952) 595-11001137 Giyanani, Ravi Physician Virtual Radiologic Profession NO 1447230289 253095 Kings 11995 Singletree Lane, Suite500 Eden Prairie MN 55344 (952) 595-11001138 Goradia, Dhawal Physician Virtual Radiologic Profession NO 1992742621 4751 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-11001139 Hodge, Richard Physician Virtual Radiologic Profession NO 1508862863 255442 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 553441140 Hurt, Christopher Physician Virtual Radiologic Profession NO 1497866214 252211 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-11001141 Hurvitz, Monica Physician Virtual Radiologic Profession NO 1841216371 248605 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-11001142 Keliddari, Farhad Physician Virtual Radiologic Profession NO 1750595682 245354 Kings 11995 Singletree Lane Suite 500 Eden Prairie MN 55344 (952) 555-66201143 Kenyherz, Gregory Physician Virtual Radiologic Profession NO 1417953795 258482 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-11001144 Klein, Susan Physician Virtual Radiologic Profession NO 1912931825 161283 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-1100






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1145 Lombino, Michael Physician Virtual Radiologic Profession NO 1194933911 3374150 260805 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-11001146 Mack, Joseph Physician Virtual Radiologic Profession NO 1467439745 244445 Kings 11995 Singletree Lane Suite 500 Eden Prairie MN 55344 (952) 595-11001147 McDonnell, Kevin Physician Virtual Radiologic Profession NO 1578548533 231950 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-11001148 Morais, Joshua Physician Virtual Radiologic Profession NO 1669674651 252455-1 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-11001149 Newman, Barbara Physician Virtual Radiologic Profession NO 1003808908 215486 Kings 11995 Singletree Lane, Suite 5000 Eden Prairie MN 55344 (952) 595-11001150 Osborne, Thomas Physician Virtual Radiologic Profession NO 1053376418 253767 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-11001151 Shirazi, Michael Physician Virtual Radiologic Profession NO 1326289679 3291834 251802 Kings 11995 Singletree Lane, Suite500 Eden Prairie MN 55344 (952) 595-11001152 Strong, Benjamin Physician Virtual Radiologic Profession NO 1205811569 236019 Kings 11995 Singletree Lane, LLC Eden Prairie MN 55344 (952) 595-11001153 Talmi, Danit Physician Virtual Radiologic Profession NO 1851326425 254689 Kings 11995 Singletree Lane suite500 Eden Prairie MN 55344 (952) 595-11001154 Toothman, Richard Physician Virtual Radiologic Profession NO 1487629143 243801 Kings 11995 Singletree Lane, Suite500 Eden Prairie MN 55344 (952) 595-11001155 Turner, James Physician Virtual Radiologic Profession NO 1790760064 241766 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-11001156 Vidan, Erez Physician Virtual Radiologic Profession NO 1982818373 3293565 238696 Kings 11995 Singletree Lane, Suite 500 Eden Prairie MN 55344 (952) 595-93521157 Zelinka, Peter Physician Virtual Radiologic Profession NO 1154458545 244815 Kings 11995 Singletree Lane Eden Prairie MN 55344 (952) 595-11001158 Von Tobel, Travis Physician Von Tobel, Travis NO 1487954723 3275110 244805 Kings1159 Walicki, Celeste Physician Walicki, Celeste YES 1639137680 1649572 183249 Kings1160 Walsh, James Physician Walsh, James NO 1255337986 1087883 152502 Kings1161 Weissbluth, Jay Physician Weissbluth, Jay NO 1659376119 101132 166454 Kings 310 East 46th Street Apt 11H New York NY 10017 (718) 934-18001162 Weltman, David Physician Weltman, David NO 1326021163 1507639 170720-1 Kings 52 Main Street Bedford Hills NY 10507 (914) 666-33201163 Wert, Sanford Physician Wert, Sanford NO 1477508661 406657 128807 Kings 3075 Brighton 13th Street Brooklyn NY 11235 (718) 332-47471164 Wubshet, Berhane Physician Wubshet, Berhane YES 1013963297 1669130 195697 Kings 9408 Flatlands Avenue Brooklyn NY 11236 (718) 272-09771165 Wynn, San San Physician Wynn, San San NO 1083687289 1864988 220806-1 Kings 723 87th Street Brooklyn NY 11236 (718) 498-57541166 Yokers, Brian Physician Yokers, Brian NO 1457667537 274175 Kings 703 Main Street Paterson NJ 7503 (973) 754-29181167 Young, Clifford Physician Young, Clifford NO 1942364286 1845610 186552 Kings 1954 Rockaway Parkway Brooklyn NY 11236 (718) 209-80021168 Zabarskiy, Roman Physician Zabarskiy, Roman NO 1871674960 2280353 225215 Kings 4546 Bedford avenue Brooklyn NY 11235 (718) 998-38001169 Zats, Alan Physicians Assistant Zats, Alan NO 1013297845 3593840 14673 Kings 813 Quentin Rd Brooklyn NY 11223 (718) 998-98901170 Zeitlin, Robert Dentist Zeitlin, Robert NO 1699985648 396323 31799 Kings 1603 Voorhies Avenue Brooklyn NY 11235 (718) 332-17781171 Ditmas Park Care Center Ditmas Park Care Center YES Kings Brooklyn NY1172 Eli Fteha Physician Ditmas Park Care Center YES 1154493575 229384 Kings 2015 E 14th Street Brooklyn NY 11223 Eli Fteha 718-627-87001173 Albert Ftiha Physician Ditmas Park Care Center YES 1174634687 228860 Kings 2136 Ocean Avenue Brooklyn NY 11203 Albert Ftiha 718-627-87001174 Frederic Sherman Physician Ditmas Park Care Center YES 1730263393 117136 Kings 8675 Bay Parkway Brooklyn NY 11214 Dr. Sherman 718-372-22341175 Dr. Rajat Mukherji Physician Ditmas Park Care Center YES 1649229188 140692 Kings 585 Schnectady Avenue Brooklyn NY 11203 Rajat Mukherji 718-604-50001176 Dr. Moe Mynt Physician Ditmas Park Care Center YES 1184642068 204488 Kings 690 92nd street Brooklyn NY 11228 Dr. Moe Mynt 718-273-77701177 Dr. Marsha Nelson Physician Ditmas Park Care Center YES 1114049459 223441 Kings 4802 10th Avenue Brooklyn NY 11219 Dr. Nelson 718-283-60001178 Ashlyn Celestin Nurse_Practitioner Ditmas Park Care Center YES 1518226869 F305485 Kings 2107 Ditmas Avenue Brooklyn NY 11226 Ashlyn Celestin 718-462-81001179 Crown Heights Center for Nursing and Rehabilitation Crown Heights Center for Nu YES Kings Brooklyn NY1180 Brutus , Pierre Physician Crown Heights Center for Nu YES 1841233046 309559 126426 Kings 716 Linden Blvd Brooklyn NY 11203 Pierre Brutus 718-693-26861181 Albian, Marco Physician Crown Heights Center for Nu YES 1225194020 309559 192803 Kings 9046 Farragut Road Brooklyn NY 11236 Marco Albian 718-257-43001182 Charnoff, Daniel Physician Crown Heights Center for Nu YES 1922006832 309559 143191 Kings 2985 Quentin Road Brooklyn NY 11229 Daniel Charnoff 718-645-50001183 Costa, John Physician Crown Heights Center for Nu YES 1700947454 309559 143646 Kings 3858 Nostrand Avenue Brooklyn NY 11235 John Costa 718-332-43531184 Isakov, Alexey Physician Crown Heights Center for Nu YES 1093798746 309559 197260 Kings 134 Brighton 11th Street Brooklyn NY 11235 Alexey Isakov 718-616-16261185 Khabyeh, Shaya Physician Crown Heights Center for Nu YES 1346299047 309559 217758 Kings 645 Crawford Avenue Brooklyn NY 11223 Shaya Khabyeh 718-368-27221186 Mango, Angelo Physician Crown Heights Center for Nu YES 1164422796 309559 165641 Kings 207 Prospect Park West Brooklyn NY Angelo Mango 718-434-20821187 Sotnik, Regina Physician Crown Heights Center for Nu YES 1912952466 309559 212528 Kings 2146 Beverly Road Brooklyn NY 11226 Regina Sotnik 718-469-66001188 Lemare, Glenda Nurse_Practitioner Crown Heights Center for Nursing and Rehabi 1316974264 309559 304269 Westchester 3 Barker Ave. White Plains NY 10601 Glenda Lemare 914-949-11991189 Boakye-Yiadom, Folashade Dentist Denserv Group 46251 Westchester 15 Canal Road Pelham Manor NY 10803 Folashade Boakye-Yiadom 914-738-11441190 Brownsville Family Health Center Brownsville Family Health C YES Kings Brooklyn NY1191 Rosemarie Regis Physician Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151192 Ericka Rivera-De La Cruz FNP Nurse_Practitioner Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151193 Virginia Robertson, MD Physician Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151194 Juan Sandoval, MD Physician Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151195 Bonann Gill, RDH Dentist Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151196 Richard Smith Physician Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 1115






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1197 Camille Taylor-Mullings MD Physician Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151198 Celeste L Walicki, DO Physician Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151199 Vernon Williams, PA Physicians Assistant Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151200 Tanya Zangaglia, MD Physician Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151201 Gina Cadet, RPA Physicians Assistant Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151202 Amber Featherston, MD Physician Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151203 Rhoena Worrell Pierre, NP Nurse_Practitioner Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151204 Stephanie Droz-Toro Dentist Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151205 Tricia Quartey Dentist Brownsville Family Health C Yes 1578612413 Kings 592 Rockaway Brooklyn NY 11212 Camille Mullings-Taylor (71) 834-5500 11151206 The Brooklyn Hospital Center The Brooklyn Hospital Cente YES Kings Brooklyn NY1207 Maryam Mirzaagha Certified_Nurse_Midwife TBHC Physician Services, PC NO 1417209651 001482 Kings 121 Dekalb Ave Brooklyn NY 11201 Maryam Mirzaagha (718)250-69301208 Mimi Maulella Certified_Nurse_Midwife TBHC Physician Services, PC NO 1154448678 000231 Kings 121 Dekalb Ave Brooklyn NY 11201 Mimi Maulella (718)250-69301209 Yvette Byer-Henry Certified_Nurse_Midwife TBHC Physician Services, PC NO 1306992409 02181946 000876 Kings 121 Dekalb Ave Brooklyn NY 11201 Yvette Byer-Henry (718)250-69301210 Amy Rosenthal Certified_Nurse_Midwife TBHC Physician Services, PC NO 1275705576 02532272 001024 Kings 121 Dekalb Ave Brooklyn NY 11201 Amy Rosenthal (718)769-48971211 Laurie Brucia Certified_Nurse_Midwife TBHC Physician Services, PC NO 1063661973 001504 Kings 121 Dekalb Ave Brooklyn NY 11201 Laurie Brucia (305)332-45201212 Mimi Maulella Certified_Nurse_Midwife TBHC Physician Services, PC NO 1154448678 372222 Kings 121 Dekalb Ave Brooklyn NY 11201 Mimi Maulella (718)250-69301213 Yvette Byer-Henry Certified_Nurse_Midwife TBHC Physician Services, PC NO 1306992409 02181946 461691 Kings 121 Dekalb Ave Brooklyn NY 11201 Yvette Byer-Henry (718)250-69301214 Amy Rosenthal Certified_Nurse_Midwife TBHC Physician Services, PC NO 1275705576 02532272 505363 Kings 121 Dekalb Ave Brooklyn NY 11201 Amy Rosenthal (718)769-48971215 Laurie Brucia Certified_Nurse_Midwife TBHC Physician Services, PC NO 1063661973 660154 Kings 121 Dekalb Ave Brooklyn NY 11201 Laurie Brucia (305)332-45201216 Samy Morcos Dentist NO 1447392345 032731 Kings 121 Dekalb Ave Brooklyn NY 11201 Samy Morcos (718)250-89631217 Earl Clarkson Dentist NO 1659397578 036255 Kings 121 Dekalb Ave Brooklyn NY 11201 Earl Clarkson (718)250-82581218 Harry Dym Dentist NO 1366538910 036617 Kings 121 Dekalb Ave Brooklyn NY 11201 Harry Dym (718)250-82581219 Marc Sadowsky Dentist NO 1669655098 042435 Kings 121 Dekalb Ave Brooklyn NY 11201 Marc Sadowsky (718)258-24621220 Reena Clarkson Dentist NO 045045 Kings 121 Dekalb Ave Brooklyn NY 11201 Reena Clarkson (718)250-82581221 Michael Chan Dentist NO 1093769317 045149 Kings 121 Dekalb Ave Brooklyn NY 11201 Michael Chan (718)630-36511222 Chia-Hung Yuan Dentist NO 1982730180 050843 Kings 121 Dekalb Ave Brooklyn NY 11201 Chia-Hung Yuan (718)455-90001223 Avichai Stern Dentist NO 1275704355 051512 Kings 121 Dekalb Ave Brooklyn NY 11201 Avichai Stern (718)250-89631224 Ricardo Boyce Dentist NO 1265564546 051723 Kings 121 Dekalb Ave Brooklyn NY 11201 Ricardo Boyce (718)250-89631225 Florine Abraham Dentist NO 1821439688 056789 Kings 121 Dekalb Ave Brooklyn NY 11201 Florine Abraham (718)250-82581226 Joshua Wolf Dentist NO 1346484342 057158 Kings 121 Dekalb Ave Brooklyn NY 11201 Joshua Wolf (718)250-82581227 Toula Mylonakis Dentist NO 1164562336 052542 Kings 121 Dekalb Ave Brooklyn NY 11201 Toula Mylonakis (718)250-82581228 Marisela Garau-Gonzalez Dentist NO 1326378860 054631 Kings 121 Dekalb Ave Brooklyn NY 11201 Marisela Garau-Gonzalez1229 Anders Cohen Physician TBHC Physician Services, PC NO 1316967003 02659387 217215 Kings 121 Dekalb Ave Brooklyn NY 11201 Anders Cohen (718)250-81031230 Chao Chen Physician TBHC Medical Services, PC NO 1821010653 02198612 222752 Kings 121 Dekalb Ave Brooklyn NY 11201 Chao Chen (718)349-85001231 Alejandra Uribe Physician TBHC Medical Services, PC YES 1578505392 227057 Kings 121 Dekalb Ave Brooklyn NY 11201 Alejandra Uribe (718)250-84441232 Louis Gerolemou Physician TBHC Physician Services, PC YES 1104919323 02760534 240293-1 Kings 121 Dekalb Ave Brooklyn NY 11201 Louis Gerolemou (718)780-14711233 Maxim Shulimovich Physician TBHC Physician Services, PC NO 1326297318 253050 Kings 121 Dekalb Ave Brooklyn NY 11201 Maxim Shulimovich (718)250-81011234 Charles Russo Physician TBHC Physician Services, PC NO 1942264189 003120 Kings 121 Dekalb Ave Brooklyn NY 11201 Charles Russo (718)638-81851235 Ovidio Falcone Physician TBHC Physician Services, PC NO 1477555415 01065807 004171 Kings 121 Dekalb Ave Brooklyn NY 11201 Ovidio Falcone (718)250-86561236 Sumit Dharia Physician NO 1194742932 006032 Kings 121 Dekalb Ave Brooklyn NY 11201 Sumit Dharia (718)250-67971237 Vito LaPuma Physician TBHC Physician Services, PC NO 1790018059 03195168 006338 Kings 121 Dekalb Ave Brooklyn NY 11201 Vito LaPuma (212)661-33001238 Rupal Oza Physician TBHC Physician Services, PC NO 1568626034 006429 Kings 121 Dekalb Ave Brooklyn NY 11201 Rupal Oza (718)424-49891239 Fred Gilbert Physician TBHC Pediatric Services, PC NO 1609993641 01102923 102024 Kings 121 Dekalb Ave Brooklyn NY 11201 Fred Gilbert (718)250-69111240 Deepak Setia Physician NO 1285640698 132693 Kings 121 Dekalb Ave Brooklyn NY 11201 Deepak Setia (718)821-12221241 Haamid Chamdawala Physician TBHC Pediatric Services, PC NO 1902156094 03519931 004133 Kings 121 Dekalb Ave Brooklyn NY 11201 Haamid Chamdawala (718)250-69171242 Kathleen Grima Physician TBHC Medical Testing Servic NO 1033256201 035072 Kings 121 Dekalb Ave Brooklyn NY 11201 Kathleen Grima (718)250-82181243 Howard Friedman Physician TBHC Physician Services, PC YES 1386796092 00175640 101952 Kings 121 Dekalb Ave Brooklyn NY 11201 Howard Friedman (718)250-69251244 Peter Smith Physician TBHC Physician Services, PC YES 1366404352 00184267 105457 Kings 121 Dekalb Ave Brooklyn NY 11201 Peter Smith (718)780-29051245 Matthew Kaplan Physician TBHC Pediatric Services, PC YES 1659332419 00189588 107567 Kings 121 Dekalb Ave Brooklyn NY 11201 Matthew Kaplan (718)250-69111246 Howard Lantz Physician TBHC Pediatric Services, PC YES 1922012657 00436159 110744 Kings 121 Dekalb Ave Brooklyn NY 11201 Howard Lantz (718)250-86711247 Abraham Jelin Physician TBHC Pediatric Services, PC YES 1043204068 00247347 116569 Kings 121 Dekalb Ave Brooklyn NY 11201 Abraham Jelin (718)250-62771248 David Wolin Physician Brooklyn Hospital Radiology NO 1992704597 00647190 121284 Kings 121 Dekalb Ave Brooklyn NY 11201 David Wolin (718)250-8230






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1249 Jacob Warman Physician TBHC Physician Services, PC YES 1144336116 00350110 122805 Kings 121 Dekalb Ave Brooklyn NY 11201 Jacob Warman (718)250-89951250 Sung Chung Physician TBHC Pediatric Services, PC YES 1184714354 00427550 123628 Kings 121 Dekalb Ave Brooklyn NY 11201 Sung Chung (718)250-89681251 David Sussman Physician YES 1164586988 124363 Kings 121 Dekalb Ave Brooklyn NY 11201 David Sussman (718)783-21111252 Kenneth Bromberg Physician TBHC Pediatric Services, PC YES 1922092063 00500541 127853 Kings 121 Dekalb Ave Brooklyn NY 11201 Kenneth Bromberg (718)250-69341253 Stephen Ajl Physician TBHC Pediatric Services, PC YES 1629092119 00465485 128272 Kings 121 Dekalb Ave Brooklyn NY 11201 Stephen Ajl (718)250-87641254 William Heneghan Physician NO 1699722132 131572 Kings 121 Dekalb Ave Brooklyn NY 11201 William Heneghan (718)250-81621255 Mark Leber Physician TBHC Emergency Medicine, YES 1629090634 00834506 133149 Kings 121 Dekalb Ave Brooklyn NY 11201 Mark Leber (718)579-60251256 Richard Pearl Physician NO 1780831404 133973 Kings 121 Dekalb Ave Brooklyn NY 11201 Richard Pearl (212)308-25401257 Romulo Genato Physician NO 1821104993 134172 Kings 121 Dekalb Ave Brooklyn NY 11201 Romulo Genato (718)250-89701258 Gloria Rapoport Physician Brooklyn Hospital Radiology NO 1316973951 01391708 136292 Kings 121 Dekalb Ave Brooklyn NY 11201 Gloria Rapoport (718)250-82391259 Ramesh Gulrajani Physician TBHC Physician Services, PC YES 1801901327 00561546 136710 Kings 121 Dekalb Ave Brooklyn NY 11201 Ramesh Gulrajani (718)250-69501260 Swayamprabha Sadanandan Physician YES 1306893201 137345 Kings 121 Dekalb Ave Brooklyn NY 11201 Swayamprabha Sadanandan (718)250-60741261 Henry Ferstenberg Physician NO 1932121779 139924 Kings 121 Dekalb Ave Brooklyn NY 11201 Henry Ferstenberg (212)768-05621262 Sirisha Tikko Physician TBHC Physician Services, PC NO 1497856041 01025896 140979 Kings 121 Dekalb Ave Brooklyn NY 11201 Sirisha Tikko (718)250-81401263 Candace Erickson Physician TBHC Pediatric Services, PC NO 1629139647 00672335 141409 Kings 121 Dekalb Ave Brooklyn NY 11201 Candace Erickson (212)362-22601264 Viswanath Vasudevan Physician TBHC Physician Services, PC YES 1558357558 01299256 142946 Kings 121 Dekalb Ave Brooklyn NY 11201 Viswanath Vasudevan (718)250-69501265 Michael Cabbad Physician YES 1356364863 143822 Kings 121 Dekalb Ave Brooklyn NY 11201 Michael Cabbad (718)250-83021266 Stuart Green Physician TBHC Medical Testing, PC YES 1043220825 00893187 144291 Kings 121 Dekalb Ave Brooklyn NY 11201 Stuart Green (718)250-69211267 In-suk Seo Physician Brooklyn Hospital Radiology NO 1710922406 01007698 145037 Kings 121 Dekalb Ave Brooklyn NY 11201 In-suk Seo (718)250-82251268 Leonard Berkowitz Physician TBHC Physician Services, PC YES 1265534564 00787788 145179 Kings 121 Dekalb Ave Brooklyn NY 11201 Leonard Berkowitz (718)250-61411269 Errol Mallett Physician NO 1992785315 146738 Kings 121 Dekalb Ave Brooklyn NY 11201 Errol Mallett (718)773-02441270 Belen Fineza Physician TBHC Pediatric Services, PC NO 1902914997 00669521 147360 Kings 121 Dekalb Ave Brooklyn NY 11201 Belen Fineza (718)250-62831271 Vijay Mattoo Physician TBHC Physician Services, PC NO 1780625277 00772538 148329 Kings 121 Dekalb Ave Brooklyn NY 11201 Vijay Mattoo (718)250-69601272 Francis Williams Physician TBHC Physician Services, PC NO 1366530966 149655 Kings 121 Dekalb Ave Brooklyn NY 11201 Francis Williams (718)250-68801273 David Sherr Physician Brooklyn Hospital Radiology NO 1083728943 01438182 150638 Kings 121 Dekalb Ave Brooklyn NY 11201 David Sherr (718)250-82601274 Kathleen Grima Physician TBHC Medical Testing Servic NO 1033256201 153981 Kings 121 Dekalb Ave Brooklyn NY 11201 Kathleen Grima (718)250-82181275 Olumide Osoba Physician TBHC Physician Services, PC NO 1710904560 00815403 155213 Kings 121 Dekalb Ave Brooklyn NY 11201 Olumide Osoba (718)250-61201276 Mary Bray Physician TBHC Physician Services, PC NO 1104802255 158100 Kings 121 Dekalb Ave Brooklyn NY 11201 Mary Bray (516)739-21001277 Shalom Buchbinder Physician Brooklyn Hospital Radiology NO 1477578417 00895818 158101 Kings 121 Dekalb Ave Brooklyn NY 11201 Shalom Buchbinder (718)250-82301278 Kenneth Ong Physician TBHC Physician Services, PC YES 1922098284 01228440 158664 Kings 121 Dekalb Ave Brooklyn NY 11201 Kenneth Ong (718)250-82651279 Olga Gibbons Physician TBHC Medical Services, PC YES 1689636268 00930176 161590 Kings 121 Dekalb Ave Brooklyn NY 11201 Olga Gibbons (718)349-85001280 Olga Gibbons Physician TBHC Medical Services, PC YES 1689636268 00930176 161590 Kings 121 Dekalb Ave Brooklyn NY 11201 Olga Gibbons (718)250-86211281 Darius Kohan Physician NO 1417049750 164531 Kings 121 Dekalb Ave Brooklyn NY 11201 Darius Kohan (212)472-13001282 Joshua Halpern Physician Brooklyn Hospital Radiology NO 1649241100 01344421 165127 Kings 121 Dekalb Ave Brooklyn NY 11201 Joshua Halpern (718)372-02631283 Angela Kerr Physician NO 1053421412 165697 Kings 121 Dekalb Ave Brooklyn NY 11201 Angela Kerr (718)250-83181284 Patrick Leblanc Physician TBHC Pediatric Services, PC NO 1528052586 01373160 166674 Kings 121 Dekalb Ave Brooklyn NY 11201 Patrick Leblanc (718)250-66461285 Miksha Patel Physician NO 1295773307 167089 Kings 121 Dekalb Ave Brooklyn NY 11201 Miksha Patel (718)692-46331286 Elizabeth Guevara Physician TBHC Physician Services, PC YES 1902858756 01844944 167703 Kings 121 Dekalb Ave Brooklyn NY 11201 Elizabeth Guevara (718)250-69601287 Jean Ford Physician TBHC Physician Services, PC NO 1851334668 01141684 168577 Kings 121 Dekalb Ave Brooklyn NY 11201 Jean Ford (718)250-69251288 Pushplata Siroya Physician TBHC Physician Services, PC NO 1962462390 01057478 168777 Kings 121 Dekalb Ave Brooklyn NY 11201 Pushplata Siroya (718)369-19831289 James Peloquen Physician TBHC Medical Testing Servic NO 1881788776 01202024 169458 Kings 121 Dekalb Ave Brooklyn NY 11201 James Peloquen (718)250-81711290 Eli Serur Physician NO 1104995356 170788 Kings 121 Dekalb Ave Brooklyn NY 11201 Eli Serur (718)250-81061291 Woo-taek Chang Physician NO 1437167590 171373 Kings 121 Dekalb Ave Brooklyn NY 11201 Woo-taek Chang (718)250-81591292 Sarah Rawstron Physician TBHC Pediatric Services, PC YES 1154378990 02267669 172544 Kings 121 Dekalb Ave Brooklyn NY 11201 Sarah Rawstron (718)250-69551293 Shafiqur Rahman Physician NO 1629153531 174757 Kings 121 Dekalb Ave Brooklyn NY 11201 Shafiqur Rahman (718)369-35031294 Vipul Kothari Physician TBHC Pediatric Services, PC YES 1730279514 01158507 174887 Kings 121 Dekalb Ave Brooklyn NY 11201 Vipul Kothari (718)250-86711295 Steven Kushnick Physician NO 1992754410 178322 Kings 121 Dekalb Ave Brooklyn NY 11201 Steven Kushnick (718)250-85201296 Lewis Krata Physician TBHC Pediatric Services, PC YES 1124013784 01574987 181498 Kings 121 Dekalb Ave Brooklyn NY 11201 Lewis Krata (718)250-69171297 Gardith Joseph Physician TBHC Physician Services, PC YES 1811928773 01928234 181857 Kings 121 Dekalb Ave Brooklyn NY 11201 Gardith Joseph (718)250-69601298 Jacques Duperval Physician NO 1184681033 182104 Kings 121 Dekalb Ave Brooklyn NY 11201 Jacques Duperval (718)783-51681299 Sawsan Al-Izzi Physician TBHC Physician Services, PC YES 1538279476 01851252 182902 Kings 121 Dekalb Ave Brooklyn NY 11201 Sawsan Al-Izzi (718)250-69251300 Mohammad Mir Physician TBHC Pediatric Services, PC YES 1508939190 01252368 185231 Kings 121 Dekalb Ave Brooklyn NY 11201 Mohammad Mir (718)366-8444






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1301 Sylvie De Souza Physician TBHC Medical Services, PC NO 1477590875 01717651 189977 Kings 121 Dekalb Ave Brooklyn NY 11201 Sylvie De Souza (718)250-68891302 Jedidiah Burack Physician NO 1013984392 190896 Kings 121 Dekalb Ave Brooklyn NY 11201 Jedidiah Burack (718)789-59001303 Pedro Corzo Physician TBHC Medical Services, PC YES 1275699852 01626806 191262 Kings 121 Dekalb Ave Brooklyn NY 11201 Pedro Corzo (718)250-86211304 Sandeep Sirsi Physician TBHC Physician Services, PC YES 1336138213 192158 Kings 121 Dekalb Ave Brooklyn NY 11201 Sandeep Sirsi (718)250-83201305 Emmanuel St. Louis Physician TBHC Medical Services, PC NO 1114937968 01517697 193946 Kings 121 Dekalb Ave Brooklyn NY 11201 Emmanuel St. Louis (718)250-86211306 William Shilkoff Physician TBHC Medical Testing Servic YES 1760439764 01761559 194475 Kings 121 Dekalb Ave Brooklyn NY 11201 William Shilkoff (718)250-81601307 Ronald Dailey Physician NO 1336252816 194792 Kings 121 Dekalb Ave Brooklyn NY 11201 Ronald Dailey (718)789-59001308 Nelson Menezes Physician TBHC Physician Services, PC NO 1255425948 01788783 194948 Kings 121 Dekalb Ave Brooklyn NY 11201 Nelson Menezes (718)250-62371309 Antonio Mendez Physician TBHC Emergency Medicine, NO 1538181540 01737686 195885 Kings 121 Dekalb Ave Brooklyn NY 11201 Antonio Mendez (718)250-68891310 Ahmar Butt Physician NO 1619983871 196291 Kings 121 Dekalb Ave Brooklyn NY 11201 Ahmar Butt (718)250-61201311 Akos Kovacs Physician TBHC Physician Services, PC YES 1992814560 01707648 196369 Kings 121 Dekalb Ave Brooklyn NY 11201 Akos Kovacs (718)250-69221312 Sarath Reddy Physician TBHC Physician Services, PC YES 1558334078 01740945 197190 Kings 121 Dekalb Ave Brooklyn NY 11201 Sarath Reddy (718)250-86271313 Armand Asarian Physician TBHC Physician Services, PC YES 1528150034 01749260 197573 Kings 121 Dekalb Ave Brooklyn NY 11201 Armand Asarian (718)250-60881314 Geoffrey Phillips Physician TBHC Physician Services, PC YES 1588706345 02128756 198456 Kings 121 Dekalb Ave Brooklyn NY 11201 Geoffrey Phillips (718)250-68241315 Irina Gressel Physician TBHC Physician Services, PC NO 1992727861 01592805 200255 Kings 121 Dekalb Ave Brooklyn NY 11201 Irina Gressel (718)857-00501316 Samy Fourati Physician Brooklyn Hospital Radiology NO 1235165382 01768607 201278 Kings 121 Dekalb Ave Brooklyn NY 11201 Samy Fourati (718)250-83111317 Anton Wray Physician TBHC Emergency Medicine, NO 1225050024 01717817 201768 Kings 121 Dekalb Ave Brooklyn NY 11201 Anton Wray (718)250-68891318 Nadeem Chaudhry Physician TBHC Physician Services, PC NO 1295741395 01682957 202480 Kings 121 Dekalb Ave Brooklyn NY 11201 Nadeem Chaudhry (718)921-41811319 Noah Kondamudi Physician TBHC Physician Services, PC NO 1114958451 01693576 204089 Kings 121 Dekalb Ave Brooklyn NY 11201 Noah Kondamudi (718)250-62091320 Godwin Lee Physician Brooklyn Hospital Radiology NO 1700804713 02153900 204182 Kings 121 Dekalb Ave Brooklyn NY 11201 Godwin Lee (917)650-55851321 Moshe Fuksbrumer Physician Brooklyn Hospital Radiology NO 1386644714 02010039 205465 Kings 121 Dekalb Ave Brooklyn NY 11201 Moshe Fuksbrumer (201)530-00341322 Vasantha Kondamudi Physician TBHC Medical Services, PC YES 1144238924 01841556 205727 Kings 121 Dekalb Ave Brooklyn NY 11201 Vasantha Kondamudi (718)250-86211323 Paul Rosen Physician TBHC Medical Services, PC YES 1942378443 02209974 207753 Kings 121 Dekalb Ave Brooklyn NY 11201 Paul Rosen (212)844-14371324 Benson Yeh Physician TBHC Emergency Medicine, NO 1588686588 02059396 209531 Kings 121 Dekalb Ave Brooklyn NY 11201 Benson Yeh (718)250-66501325 Gary Stephens Physician NO 1386750289 211387 Kings 121 Dekalb Ave Brooklyn NY 11201 Gary Stephens (718)250-67661326 Yonette Davis Physician TBHC Physician Services, PC YES 1871619395 02042928 211983 Kings 121 Dekalb Ave Brooklyn NY 11201 Yonette Davis (718)250-61001327 Maria Almonte Physician TBHC Medical Services, PC YES 1750459384 02048346 213386 Kings 121 Dekalb Ave Brooklyn NY 11201 Maria Almonte (718)455-90001328 Mahbub Ahmed Physician TBHC Medical Services, PC NO 1689732257 02063647 213709 Kings 121 Dekalb Ave Brooklyn NY 11201 Mahbub Ahmed (917)652-46271329 Lalasa Valasareddi Physician TBHC Physician Services, PC YES 1912936675 01983706 214410 Kings 121 Dekalb Ave Brooklyn NY 11201 Lalasa Valasareddi (718)250-89151330 Alan Saber Physician TBHC Physician Services, PC YES 1861461113 03493267 215899 Kings 121 Dekalb Ave Brooklyn NY 11201 Alan Saber (718)250-86121331 Mumtaz Jahan Physician TBHC Medical Services, PC YES 1952358079 02753400 216654 Kings 121 Dekalb Ave Brooklyn NY 11201 Mumtaz Jahan1332 Mumtaz Jahan Physician TBHC Medical Services, PC YES 1952358079 02753400 216654 Kings 121 Dekalb Ave Brooklyn NY 11201 Mumtaz Jahan1333 Roselyne Chery Physician TBHC Physician Services, PC NO 1356400998 02310552 216698 Kings 121 Dekalb Ave Brooklyn NY 11201 Roselyne Chery (718)250-65591334 Dennis Zoda Physician TBHC Medical Services, PC YES 1447297247 02582387 216808 Kings 121 Dekalb Ave Brooklyn NY 11201 Dennis Zoda (718)237-24951335 Erroll Byer Physician TBHC Physician Services, PC YES 1689682437 02094668 217043 Kings 121 Dekalb Ave Brooklyn NY 11201 Erroll Byer (718)250-66531336 Haroutyoun Margossian Physician YES 1811051592 217158 Kings 121 Dekalb Ave Brooklyn NY 11201 Haroutyoun Margossian (718)836-95791337 Rekha Bhandari Physician TBHC Physician Services, PC NO 1023035466 02134467 218001 Kings 121 Dekalb Ave Brooklyn NY 11201 Rekha Bhandari (718)821-12221338 Marie Eloi-Stiven Physician TBHC Medical Services, PC YES 1326146010 02096606 218126 Kings 121 Dekalb Ave Brooklyn NY 11201 Marie Eloi-Stiven (718)250-88171339 Irina Rondel Physician Brooklyn Hospital Radiology NO 1083660237 02501302 218329 Kings 121 Dekalb Ave Brooklyn NY 11201 Irina Rondel (718)250-82851340 Linda Michelson Physician Brooklyn Hospital Radiology NO 1063437051 02472131 218983 Kings 121 Dekalb Ave Brooklyn NY 11201 Linda Michelson (917)499-10511341 Madhavi Reddy Physician TBHC Physician Services, PC NO 1467565499 02457858 219727 Kings 121 Dekalb Ave Brooklyn NY 11201 Madhavi Reddy (718)250-88671342 Arash Gohari Physician Brooklyn Hospital Radiology NO 1134120983 02518165 219737 Kings 121 Dekalb Ave Brooklyn NY 11201 Arash Gohari (718)250-82601343 Farhad Arjomand Physician TBHC Physician Services, PC YES 1578679031 02200264 221969 Kings 121 Dekalb Ave Brooklyn NY 11201 Farhad Arjomand (718)250-69501344 Michael Hochberg Physician TBHC Emergency Medicine, NO 1932279114 02530243 223145 Kings 121 Dekalb Ave Brooklyn NY 11201 Michael Hochberg (718)250-68891345 Naveen Goyal Physician NO 1558322594 223900 Kings 121 Dekalb Ave Brooklyn NY 11201 Naveen Goyal (718)250-69401346 Yan Li Physician TBHC Pediatric Services, PC YES 1508803792 02318894 224007 Kings 121 Dekalb Ave Brooklyn NY 11201 Yan Li (917)470-99421347 Dalan Read Physician TBHC Pediatric Services, PC YES 1811975444 225535 Kings 121 Dekalb Ave Brooklyn NY 11201 Dalan Read (718)569-75541348 Aziza Sedrak-Ghaly Physician TBHC Pediatric Services, PC YES 1528228343 02398176 226480 Kings 121 Dekalb Ave Brooklyn NY 11201 Aziza Sedrak-Ghaly (718)250-60741349 Philip Xiao Physician TBHC Medical Testing Servic NO 1710928163 02548043 226692 Kings 121 Dekalb Ave Brooklyn NY 11201 Philip Xiao (718)250-82071350 Mahmoud Dakhel Physician Brooklyn Hospital Radiology NO 1881644359 03101237 226952 Kings 121 Dekalb Ave Brooklyn NY 11201 Mahmoud Dakhel (201)418-18201351 Jean Renaud Physician TBHC Medical Services, PC YES 1235177668 02519919 226985 Kings 121 Dekalb Ave Brooklyn NY 11201 Jean Renaud (718)250-84441352 Ciprian Nedelcu Physician TBHC Physician Services, PC YES 1932134970 02811838 231375 Kings 121 Dekalb Ave Brooklyn NY 11201 Ciprian Nedelcu (718)250-8265






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1353 Andras Fenyves Physician NO 1952467318 232171 Kings 121 Dekalb Ave Brooklyn NY 11201 Andras Fenyves (718)852-52221354 Inacia Besada Physician TBHC Pediatric Services, PC YES 1891732772 02296660 232667 Kings 121 Dekalb Ave Brooklyn NY 11201 Inacia Besada (718)599-62001355 Dana Spivak Physician TBHC Medical Services, PC NO 1285642934 02631996 233463 Kings 121 Dekalb Ave Brooklyn NY 11201 Dana Spivak (718)250-84441356 Mohammed Aladdin Physician Brooklyn Hospital Radiology NO 1104856822 02635041 233603 Kings 121 Dekalb Ave Brooklyn NY 11201 Mohammed Aladdin (718)250-61371357 Joseph Abboud Physician YES 1710168901 02947400 233966 Kings 121 Dekalb Ave Brooklyn NY 11201 Joseph Abboud (718)250-86251358 Eric Gordon Physician TBHC Physician Services, PC YES 1336312727 03146701 234113 Kings 121 Dekalb Ave Brooklyn NY 11201 Eric Gordon1359 Manjula Chatterjee Physician TBHC Pediatric Services, PC YES 1164625745 02941308 234874 Kings 121 Dekalb Ave Brooklyn NY 11201 Manjula Chatterjee (718)250-80171360 Pyone Maung Physician NO 1205866357 235540 Kings 121 Dekalb Ave Brooklyn NY 11201 Pyone Maung (718)789-59001361 Adebayo Adeyinka Physician TBHC Medical Services, PC NO 1205912524 02984765 236698 Kings 121 Dekalb Ave Brooklyn NY 11201 Adebayo Adeyinka (718)250-64861362 Sushil Duddempudi Physician NO 1518158427 236703 Kings 121 Dekalb Ave Brooklyn NY 11201 Sushil Duddempudi (718)852-83751363 Yesenia Morales Physician TBHC Pediatric Services, PC NO 1750541819 03025445 237295 Kings 121 Dekalb Ave Brooklyn NY 11201 Yesenia Morales (718)250-85251364 Madhu Voddi Physician TBHC Pediatric Services, PC YES 1619061306 02689976 237856 Kings 121 Dekalb Ave Brooklyn NY 11201 Madhu Voddi (718)250-87931365 Linus Yoe Physician TBHC Physician Services, PC NO 1457467193 02680275 238459 Kings 121 Dekalb Ave Brooklyn NY 11201 Linus Yoe (718)250-61201366 Shah Giashuddin Physician TBHC Medical Testing Servic NO 1538370929 238546 Kings 121 Dekalb Ave Brooklyn NY 11201 Shah Giashuddin (718)250-81641367 Louisdon Pierre Physician TBHC Medical Services, PC YES 1477569549 01900581 239391 Kings 121 Dekalb Ave Brooklyn NY 11201 Louisdon Pierre (718)250-62781368 Melissa Guillaume Physician TBHC Pediatric Services, PC YES 1497913842 03123255 241069 Kings 121 Dekalb Ave Brooklyn NY 11201 Melissa Guillaume (718)250-69191369 George Noumi Physician NO 1215001375 02910805 242340 Kings 121 Dekalb Ave Brooklyn NY 11201 George Noumi (718)567-07301370 Kannan Muralikrishnan Physician TBHC Physician Services, PC YES 1053489955 02859401 242352 Kings 121 Dekalb Ave Brooklyn NY 11201 Kannan Muralikrishnan (718)250-69301371 Irina Erlikh Physician TBHC Medical Services, PC YES 1932302155 02944470 242461 Kings 121 Dekalb Ave Brooklyn NY 11201 Irina Erlikh (718)250-85331372 Edward Chew Physician TBHC Emergency Medicine, NO 1235321241 242638 Kings 121 Dekalb Ave Brooklyn NY 11201 Edward Chew (646)530-31931373 Sherly Abraham Physician TBHC Medical Services, PC YES 1801008099 02903359 244000 Kings 121 Dekalb Ave Brooklyn NY 11201 Sherly Abraham (718)250-84451374 Alan Go Physician NO 1023109394 244988 Kings 121 Dekalb Ave Brooklyn NY 11201 Alan Go (718)250-69201375 Anjali Bakshi Physician TBHC Physician Services, PC YES 1801080957 02902183 245429 Kings 121 Dekalb Ave Brooklyn NY 11201 Anjali Bakshi (718)250-69221376 Joshua Rosenberg Physician TBHC Physician Services, PC NO 1629264924 02915502 246111 Kings 121 Dekalb Ave Brooklyn NY 11201 Joshua Rosenberg (718)250-68051377 Joshua Rosenberg Physician TBHC Physician Services, PC NO 1629264924 02915502 246111 Kings 121 Dekalb Ave Brooklyn NY 11201 Joshua Rosenberg (718)250-68051378 Joshua Rosenberg Physician TBHC Physician Services, PC NO 1629264924 02915502 246111 Kings 121 Dekalb Ave Brooklyn NY 11201 Joshua Rosenberg (718)250-68051379 Natasha Fievre Physician TBHC Physician Services, PC YES 1457507360 03026886 248632 Kings 121 Dekalb Ave Brooklyn NY 11201 Natasha Fievre (718)250-69301380 Fairouz Hasselmark Physician TBHC Physician Services, PC YES 1265602833 03503317 249042 Kings 121 Dekalb Ave Brooklyn NY 11201 Fairouz Hasselmark (646)831-25301381 Mayank Shukla Physician TBHC Pediatric Services, PC NO 1356403042 02514730 249523 Kings 121 Dekalb Ave Brooklyn NY 11201 Mayank Shukla (718)250-84321382 Bahar Bybordi Physician TBHC Physician Services, PC YES 1548416589 03052288 249857 Kings 121 Dekalb Ave Brooklyn NY 11201 Bahar Bybordi (718)250-69301383 Ahmet Altiner Physician TBHC Physician Services, PC NO 1013112952 03347293 250489 Kings 121 Dekalb Ave Brooklyn NY 11201 Ahmet Altiner (347)855-33761384 Majo Joseph Physician TBHC Physician Services, PC NO 1649416066 03132432 251115 Kings 121 Dekalb Ave Brooklyn NY 11201 Majo Joseph (718)250-69351385 Heather MacAdam Physician NO 1023253580 03154354 251793 Kings 121 Dekalb Ave Brooklyn NY 11201 Heather MacAdam (267)253-79711386 Altaf Shaik Physician TBHC Medical Services, PC YES 1891938825 03095503 252163 Kings 121 Dekalb Ave Brooklyn NY 11201 Altaf Shaik (718)216-57671387 Virender Hak Physician TBHC Medical Services, PC NO 1558317537 02096871 252620 Kings 121 Dekalb Ave Brooklyn NY 11201 Virender Hak (718)821-12221388 Sangeet Khanna Physician TBHC Medical Testing Servic NO 1225298896 03204313 252989 Kings 121 Dekalb Ave Brooklyn NY 11201 Sangeet Khanna (718)250-81991389 Jun Levine Physician TBHC Physician Services, PC YES 1487971602 03493249 253278 Kings 121 Dekalb Ave Brooklyn NY 11201 Jun Levine (718)250-66841390 Sonia Desikan Physician TBHC Pediatric Services, PC YES 1881852739 03364936 253389 Kings 121 Dekalb Ave Brooklyn NY 11201 Sonia Desikan (718)250-62271391 Adesuwa Okesanya Physician TBHC Medical Services, PC NO 1194982579 03133153 253625 Kings 121 Dekalb Ave Brooklyn NY 11201 Adesuwa Okesanya (718)250-84441392 Victoria Dantchenko Physician TBHC Medical Services, PC YES 1811220924 03154776 253900 Kings 121 Dekalb Ave Brooklyn NY 11201 Victoria Dantchenko (732)253-72521393 Nitin Gupta Physician TBHC Pediatric Services, PC NO 1477790061 03524834 253963 Kings 121 Dekalb Ave Brooklyn NY 11201 Nitin Gupta (718)250-62271394 Igor Shorman Physician TBHC Pediatric Services, PC NO 1306076245 03236202 254070 Kings 121 Dekalb Ave Brooklyn NY 11201 Igor Shorman (718)250-62271395 Maria-Anna Vastardi Physician TBHC Physician Services, PC NO 1255640181 03347326 254944 Kings 121 Dekalb Ave Brooklyn NY 11201 Maria-Anna Vastardi (917)757-80451396 Marisa Oishi Physician NO 1295994739 03256246 255159 Kings 121 Dekalb Ave Brooklyn NY 11201 Marisa Oishi (718)250-68891397 Daniel Masri Physician Brooklyn Hospital Radiology NO 1790971489 03256246 256672 Kings 121 Dekalb Ave Brooklyn NY 11201 Daniel Masri (718)250-82301398 Michael Reichel Physician Brooklyn Hospital Radiology NO 1790001287 03227814 256753 Kings 121 Dekalb Ave Brooklyn NY 11201 Michael Reichel (516)220-18401399 Michael Meguerdichian Physician TBHC Emergency Medicine, NO 1871819524 03233061 256788 Kings 121 Dekalb Ave Brooklyn NY 11201 Michael Meguerdichian (718)250-68891400 Mei Wang Physician TBHC Physician Services, PC YES 1881915197 03267521 257377 Kings 121 Dekalb Ave Brooklyn NY 11201 Mei Wang (718)851-23231401 Peter Pappas Physician TBHC Physician Services, PC YES 1801807748 03251883 257902 Kings 121 Dekalb Ave Brooklyn NY 11201 Peter Pappas (718)250-67511402 Rekha Menon Physician TBHC Medical Services, PC YES 1508166026 259010 Kings 121 Dekalb Ave Brooklyn NY 11201 Rekha Menon (718)408-49491403 Kathleen Grima Physician TBHC Medical Testing Servic NO 1033256201 25MA06313300 Kings 121 Dekalb Ave Brooklyn NY 11201 Kathleen Grima (718)250-82181404 David Hirschl Physician Brooklyn Hospital Radiology YES 1073800330 03493414 260315 Kings 121 Dekalb Ave Brooklyn NY 11201 David Hirschl (718)250-8230






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1405 Dmitry Youshko Physician TBHC Physician Services, PC YES 1508158015 03367099 260387 Kings 121 Dekalb Ave Brooklyn NY 11201 Dmitry Youshko (646)637-84531406 Sonal Bordia Physician TBHC Physician Services, PC YES 1346421781 03454148 260433 Kings 121 Dekalb Ave Brooklyn NY 11201 Sonal Bordia (718)250-69601407 Anjali Hulbanni Physician TBHC Emergency Medicine, NO 1598997025 03608633 260726 Kings 121 Dekalb Ave Brooklyn NY 11201 Anjali Hulbanni (718)250-68891408 Emily Ross Physician TBHC Emergency Medicine, NO 1700183795 03393368 261139 Kings 121 Dekalb Ave Brooklyn NY 11201 Emily Ross (718)250-68891409 Farzana Afroza Physician TBHC Physician Services, PC YES 1487944674 03490535 262075 Kings 121 Dekalb Ave Brooklyn NY 11201 Farzana Afroza (718)250-69251410 Mohammed Chowdhury Physician NO 262426 Kings 121 Dekalb Ave Brooklyn NY 11201 Mohammed Chowdhury (718)250-69201411 Akiyomi Fields Physician NO 1104118546 262611 Kings 121 Dekalb Ave Brooklyn NY 11201 Akiyomi Fields (718)789-59001412 Vijay Singh Physician Brooklyn Hospital Radiology NO 1285914770 03365695 262667 Kings 121 Dekalb Ave Brooklyn NY 11201 Vijay Singh (718)250-82301413 Jonathan Chow Physician TBHC Medical Testing Servic NO 1306008412 263787 Kings 121 Dekalb Ave Brooklyn NY 11201 Jonathan Chow (716)474-64631414 Megan Kwasniak Physician TBHC Emergency Medicine, NO 1760743512 03489058 265731 Kings 121 Dekalb Ave Brooklyn NY 11201 Megan Kwasniak (718)250-68891415 Uzoma Ukomadu Physician TBHC Physician Services, PC YES 1013111707 03493390 266266 Kings 121 Dekalb Ave Brooklyn NY 11201 Uzoma Ukomadu (718)250-77001416 Wu Tan Physician TBHC Physician Services, PC YES 1518236181 03518669 267436 Kings 121 Dekalb Ave Brooklyn NY 11201 Wu Tan (718)851-23231417 Jeanette Haslett Physician TBHC Emergency Medicine, NO 1134370810 03599497 269427 Kings 121 Dekalb Ave Brooklyn NY 11201 Jeanette Haslett1418 Upulie Nawaratne Physician TBHC Pediatric Services, PC NO 1114105038 270104 Kings 121 Dekalb Ave Brooklyn NY 11201 Upulie Nawaratne (718)250-62271419 Shumaila Khan Physician TBHC Physician Services, PC NO 1821224445 270123 Kings 121 Dekalb Ave Brooklyn NY 11201 Shumaila Khan (347)331-79551420 Rohit Pinto Physician NO 1720236151 270352 Kings 121 Dekalb Ave Brooklyn NY 11201 Rohit Pinto (718)250-85901421 Sheena Punnapuzha Physician TBHC Emergency Medicine, NO 1750626768 06328104 270498 Kings 121 Dekalb Ave Brooklyn NY 11201 Sheena Punnapuzha (917)664-13251422 Arvind Ankireddypalli Physician TBHC Medical Services, PC NO 1003162637 03782510 270803 Kings 121 Dekalb Ave Brooklyn NY 11201 Arvind Ankireddypalli (718)250-84441423 Melissa Hersh Physician TBHC Pediatric Services, PC NO 1316253545 270853 Kings 121 Dekalb Ave Brooklyn NY 11201 Melissa Hersh (917)617-42311424 Tanyka Sam Physician TBHC Physician Services, PC NO 1164653416 271647 Kings 121 Dekalb Ave Brooklyn NY 11201 Tanyka Sam (718)250-84261425 Arkady Barenboim Physician TBHC Medical Testing Servic NO 1780990499 273270 Kings 121 Dekalb Ave Brooklyn NY 11201 Arkady Barenboim (917)406-00061426 Rajesh Bhavsar Physician Brooklyn Hospital Radiology NO 1043471022 274806 Kings 121 Dekalb Ave Brooklyn NY 11201 Rajesh Bhavsar (718)250-82301427 Linda Michelson Physician Brooklyn Hospital Radiology NO 1063437051 02472131 35.060348 Kings 121 Dekalb Ave Brooklyn NY 11201 Linda Michelson (917)499-10511428 Lisa Russak Nurse_Practitioner TBHC Physician Services, PC NO 1659405835 02923760 303001 Kings 121 Dekalb Ave Brooklyn NY 11201 Lisa Russak (718)250-65341429 Omana Samuel Nurse_Practitioner NO 1932400975 00815403 303106 Kings 121 Dekalb Ave Brooklyn NY 11201 Omana Samuel (718)250-69651430 Zinnatun Hasan Nurse_Practitioner NO 1215046875 304047 Kings 121 Dekalb Ave Brooklyn NY 11201 Zinnatun Hasan (718)250-80091431 Emmanuel Appiah-Agyemang Nurse_Practitioner NO 1699832964 304472 Kings 121 Dekalb Ave Brooklyn NY 11201 Emmanuel Appiah-Agyemang (718)250-84441432 Josee Chardavoine Nurse_Practitioner TBHC Physician Services, PC NO 1477871804 304595 Kings 121 Dekalb Ave Brooklyn NY 11201 Josee Chardavoine (718)250-80581433 Cordell Maule Nurse_Practitioner NO 1982016127 305590 Kings 121 Dekalb Ave Brooklyn NY 11201 Cordell Maule (718)599-62001434 Asha Abraham Nurse_Practitioner TBHC Physician Services, PC NO 1497196257 306549 Kings 121 Dekalb Ave Brooklyn NY 11201 Asha Abraham (718)250-67021435 Rosemary Daniele Nurse_Practitioner NO 1255325064 330846 Kings 121 Dekalb Ave Brooklyn NY 11201 Rosemary Daniele (718)250-69351436 Michelle Clodomir Nurse_Practitioner NO 1700071867 335135 Kings 121 Dekalb Ave Brooklyn NY 11201 Michelle Clodomir (718)250-69351437 Gloria Wang Nurse_Practitioner TBHC Medical Services, PC NO 1427396894 337335 Kings 121 Dekalb Ave Brooklyn NY 11201 Gloria Wang (718)851-23231438 Vivian Annan Nurse_Practitioner TBHC Physician Services, PC NO 1679817118 337660 Kings 121 Dekalb Ave Brooklyn NY 11201 Vivian Annan (718)250-85291439 Emily Phipps Nurse_Practitioner TBHC Physician Services, PC NO 1841631652 03785040 338188 Kings 121 Dekalb Ave Brooklyn NY 11201 Emily Phipps (646)678-64861440 Lisa Russak Nurse_Practitioner TBHC Physician Services, PC NO 1659405835 02923760 340451 Kings 121 Dekalb Ave Brooklyn NY 11201 Lisa Russak (718)250-65341441 Maisha Maitland Nurse_Practitioner TBHC Physician Services, PC NO 1184830036 03276771 340640 Kings 121 Dekalb Ave Brooklyn NY 11201 Maisha Maitland (718)250-61051442 Michelle Clodomir Nurse_Practitioner NO 1700071867 350033 Kings 121 Dekalb Ave Brooklyn NY 11201 Michelle Clodomir (718)250-69351443 Carol Dumlao Nurse_Practitioner NO 1609078450 350159 Kings 121 Dekalb Ave Brooklyn NY 11201 Carol Dumlao (718)250-85251444 Sheba Dubos Nurse_Practitioner NO 1417234915 350300 Kings 121 Dekalb Ave Brooklyn NY 11201 Sheba Dubos (718)250-85251445 Rosemary Daniele Nurse_Practitioner NO 1255325064 355121 Kings 121 Dekalb Ave Brooklyn NY 11201 Rosemary Daniele (718)250-69351446 Carol Dumlao Nurse_Practitioner NO 1609078450 365339 Kings 121 Dekalb Ave Brooklyn NY 11201 Carol Dumlao (718)250-85251447 Sheela Thomas Nurse_Practitioner NO 1265679229 381572 Kings 121 Dekalb Ave Brooklyn NY 11201 Sheela Thomas (718)206-60001448 Tawny Lowe Nurse_Practitioner NO 1750581708 381748 Kings 121 Dekalb Ave Brooklyn NY 11201 Tawny Lowe (212)998-50731449 Saribel Quinones Nurse_Practitioner NO 1013970102 381888 Kings 121 Dekalb Ave Brooklyn NY 11201 Saribel Quinones (212)992-71291450 Katherine Magoon Nurse_Practitioner TBHC Physician Services, PC NO 1710296629 382163 Kings 121 Dekalb Ave Brooklyn NY 11201 Katherine Magoon (718)250-62271451 Omana Samuel Nurse_Practitioner NO 1932400975 402261 Kings 121 Dekalb Ave Brooklyn NY 11201 Omana Samuel (718)250-69651452 Cordell Maule Nurse_Practitioner NO 1982016127 412824 Kings 121 Dekalb Ave Brooklyn NY 11201 Cordell Maule (718)599-62001453 Emmanuel Appiah-Agyemang Nurse_Practitioner NO 1699832964 438856 Kings 121 Dekalb Ave Brooklyn NY 11201 Emmanuel Appiah-Agyemang (718)250-84441454 Sheela Thomas Nurse_Practitioner NO 1265679229 458862 Kings 121 Dekalb Ave Brooklyn NY 11201 Sheela Thomas (718)206-60001455 Maisha Maitland Nurse_Practitioner TBHC Physician Services, PC NO 1184830036 03276771 460413 Kings 121 Dekalb Ave Brooklyn NY 11201 Maisha Maitland (718)250-61051456 Zinnatun Hasan Nurse_Practitioner NO 1215046875 486633 Kings 121 Dekalb Ave Brooklyn NY 11201 Zinnatun Hasan (718)250-8009






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1457 Lisa Russak Nurse_Practitioner TBHC Physician Services, PC NO 1659405835 02923760 497857 Kings 121 Dekalb Ave Brooklyn NY 11201 Lisa Russak (718)250-65341458 Vivian Annan Nurse_Practitioner TBHC Physician Services, PC NO 1679817118 518758 Kings 121 Dekalb Ave Brooklyn NY 11201 Vivian Annan (718)250-85291459 Gloria Wang Nurse_Practitioner TBHC Medical Services, PC NO 1427396894 547177 Kings 121 Dekalb Ave Brooklyn NY 11201 Gloria Wang (718)851-23231460 Tawny Lowe Nurse_Practitioner NO 1750581708 551614 Kings 121 Dekalb Ave Brooklyn NY 11201 Tawny Lowe (212)998-50731461 Sheba Dubos Nurse_Practitioner NO 1417234915 574759 Kings 121 Dekalb Ave Brooklyn NY 11201 Sheba Dubos (718)250-85251462 Saribel Quinones Nurse_Practitioner NO 1013970102 580001 Kings 121 Dekalb Ave Brooklyn NY 11201 Saribel Quinones (212)992-71291463 Emily Phipps Nurse_Practitioner TBHC Physician Services, PC NO 1841631652 03785040 608827 Kings 121 Dekalb Ave Brooklyn NY 11201 Emily Phipps (646)678-64861464 Katherine Magoon Nurse_Practitioner TBHC Physician Services, PC NO 1710296629 631454 Kings 121 Dekalb Ave Brooklyn NY 11201 Katherine Magoon (718)250-62271465 Asha Abraham Nurse_Practitioner TBHC Physician Services, PC NO 1497196257 665336 Kings 121 Dekalb Ave Brooklyn NY 11201 Asha Abraham (718)250-67021466 Bedford Stuyvesant Family Health Center Bedford Stuyvesant Family H YES Kings Brooklyn NY1467 Linda Bastien Physician Bedford Stuyvesant Family H YES 1346280542 3030155 229297 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601468 Ngozi Oji Physician Bedford Stuyvesant Family H YES 1720047251 1816706 203718 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601469 Jacqueline McGibbon Physician Bedford Stuyvesant Family H YES 1467412742 1652111 201443 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601470 Danil Rafailov Physician Bedford Stuyvesant Family H YES 1598904013 3142683 250780 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601471 Jean-Claude Desrosiers Physician Bedford Stuyvesant Family H YES 1578713806 3608913 259032 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601472 Ehab Hana Physician Bedford Stuyvesant Family H YES 1295019198 3723815 271276 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601473 Viresh Kumar Physician Bedford Stuyvesant Family H YES 1932169711 2716627 255497 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601474 Pascale Kersaint Physician Bedford Stuyvesant Family H YES 1649239120 2778476 237340 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601475 Hosayne S. Heydarpour Physician Bedford Stuyvesant Family H YES 1720164452 2913399 224734 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601476 Claude Offord Physician Bedford Stuyvesant Family H YES 1801992672 1833747 157567 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601477 Agathi Vallianatos Physician Bedford Stuyvesant Family H YES 1750479358 233651 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601478 Pauline Walks Physician Bedford Stuyvesant Family H YES 1063434447 156958 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601479 Margaret Newsam Physician Bedford Stuyvesant Family H YES 1588740260 1723968 194562 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601480 Gilda Fernandez-Nafarrete Physician Bedford Stuyvesant Family H YES 1326001397 1452208 190417 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601481 Jose Castro Physician Bedford Stuyvesant Family H YES 1700843620 1723142 180859 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601482 Nonyelu Anyichie Physician Bedford Stuyvesant Family H YES 1326129339 2734063 222949 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601483 Barry Savits Physician Bedford Stuyvesant Family H YES 1598758542 00132045 085812 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601484 Peter Nnaemeka Physician Bedford Stuyvesant Family H YES 1699734921 1008873 145021 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601485 Buddhadev Manvar Physician Bedford Stuyvesant Family H YES 1629061833 00709628 139432 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601486 Oliver Mackey Physician Bedford Stuyvesant Family H YES 1003811050 1130276 N 004410 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601487 Lindsey Leinbach Nurse_Practitioner Bedford Stuyvesant Family H YES 1801143367 338176 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601488 Michael Agyeman Nurse_Practitioner Bedford Stuyvesant Family H YES 1427377761 335896 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601489 Carol Clapman Nurse_Practitioner Bedford Stuyvesant Family H YES 1780659409 332904 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601490 Charles Beard Dentist Bedford Stuyvesant Family H YES 1558338087 1485658 043006 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601491 Renrick Benn Dentist Bedford Stuyvesant Family H YES 1851325757 1459137 040700 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601492 Luzmarina Coffey Dentist Bedford Stuyvesant Family H YES 1376511733 2424197 043719 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601493 Aronica B. Holmes Dentist Bedford Stuyvesant Family H YES 1992137699 056841 Kings 1456 Fulton Street Brooklyn NY 11216 Dr. Pascale Kersaint 718-636-4500 3601494 Interfaith Medical Center IPA Interfaith Medical Center IP YES Kings Brooklyn NY1495 Mark Adler Physician Interfaith Medical Center IP YES 1609991868 01110347 108126 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1496 Alexander Adotey Physician Interfaith Medical Center IP YES 1144314790 00965279 166510 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1497 Imtiaz Ahmad Physician Interfaith Medical Center IP YES 1962494997 243670 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1498 Shamim Ahmed Physician Interfaith Medical Center IP YES 1003839655 2322732 237709 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1499 Hamid Alam Physician Interfaith Medical Center IP YES 1285659649 853551 240456 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1500 Curtis Amos Physician Interfaith Medical Center IP YES 1790953396 521108 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1501 Carmin Appolon Physician Interfaith Medical Center IP YES 1124052394 00918658 162825 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1502 Edmond Balakhane Physician Interfaith Medical Center IP YES 1992787121 203666 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1503 Sara Banerjee Physician Interfaith Medical Center IP YES 1194928416 268446 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071504 Rajyasri Bangaru Physician Interfaith Medical Center IP YES 1255411724 00822702 157635 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1505 Juan Baturone Physician Interfaith Medical Center IP YES 1114149051 00199179 199179 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1506 Marie-Francoise Bauduy Physician Interfaith Medical Center IP YES 1184707770 01648397 188954 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1507 Max Beaudouin Physician Interfaith Medical Center IP YES 1689686719 00336961 141584 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1508 Rodney Becher Physician Interfaith Medical Center IP YES 1538165634 00278193 120293 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-4000






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1509 Joseph Bernadotte Physician Interfaith Medical Center IP YES 1770597288 00847489 151875 Kings 1322 Bedford Avenue, Brooklyn NY 11216 Brooklyn NY 11216 (718) 613-4000 1510 Rajendra Bhayani Physician Interfaith Medical Center IP YES 1467491423 02608428 226427 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-4000 1511 Khaleda Billah Physician Interfaith Medical Center IP YES 1184643561 149482 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1512 Marsha Jane Bitter Physician Interfaith Medical Center IP YES 1124000674 146892 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1513 Marie Blaise Physician Interfaith Medical Center IP YES 1902810359 1889963 155094 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1514 Michael Bloss Physician Interfaith Medical Center IP YES 1801854732 248478 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071515 Sadhana Bose Physician Interfaith Medical Center IP YES 1003035288 02081565 210206 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1516 Cathy Boyke Physician Interfaith Medical Center IP YES 1306818257 9924 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1517 Emmanuel Brunot Physician Interfaith Medical Center IP YES 1295896223 01530478 193810 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-4000 1518 Eugene Burke Physician Interfaith Medical Center IP YES 1083787543 03389397 204881-1 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1519 Joy Byron Physician Interfaith Medical Center IP YES 1205803905 1061391 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1520 Bruce Campbell Physician Interfaith Medical Center IP YES 1780666883 01749802 192141 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071521 Jeffrey Carlson Physician Interfaith Medical Center IP YES 1538133095 261231 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071522 Pradeep Chandra Physician Interfaith Medical Center IP YES 1750349148 00743339 117367 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1523 Albert Chang Physician Interfaith Medical Center IP YES 1083869226 03119257 252856 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071524 Jeff Cheung Physician Interfaith Medical Center IP YES 1174548440 2097496 208501 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1525 Raveendra Chigurupati Physician Interfaith Medical Center IP YES 1538438858 03532318 41291 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1526 Elvira Cho Physician Interfaith Medical Center IP YES 1467619742 01643163 164611 Kings 1546 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1527 Atul Chokshi Physician Interfaith Medical Center IP YES 1386677664 00559673 136973 Kings 1546 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 - 1528 Marcia Chung Physician Interfaith Medical Center IP YES 1285907535 267251 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1529 Laurence Cloutier-Champagne Physician Interfaith Medical Center IP YES 1811254725 N006470-1 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1530 Albert Cooper Physician Interfaith Medical Center IP YES 1790753861 1985428 215652 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1531 Luis Cruz Physician Interfaith Medical Center IP YES 1114979556 01626851 197141 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1532 Venee Cunningham Physician Interfaith Medical Center IP YES 1639340706 03156127 12499 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1533 Herman Del Arca Physician Interfaith Medical Center IP YES 1073500518 231705 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 112131534 James DeMeo Physician Interfaith Medical Center IP YES 1992709455 01578972 5041 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1535 Reginald Denis Physician Interfaith Medical Center IP YES 1699984682 02881276 243694 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071536 Freddy Desormeaux Physician Interfaith Medical Center IP YES 1639246929 03100167 250020 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1537 AnnMarie Desrosiers Physician Interfaith Medical Center IP YES 199325-1 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1538 Henri Desrosiers Physician Interfaith Medical Center IP YES 1487613386 476049 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1539 Ingrid Dowrich Physician Interfaith Medical Center IP YES 1982730982 01783733 43425 Kings 1536 Bedford Avenue, Brooklyn NY 11216 Brooklyn NY 11216 (718) 613- 7375 1540 Alix Dufresne Physician Interfaith Medical Center IP YES 1700819950 00859485 157033 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1541 Herold Duroseau Physician Interfaith Medical Center IP YES 1811998883 01422031 192165 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1542 Jean-Paul Dym Physician Interfaith Medical Center IP YES 1376741157 226375 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071543 Obunike Edokwe Physician Interfaith Medical Center IP YES 1306848080 180533 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1544 Natarajan Elangovan Physician Interfaith Medical Center IP YES 1649203530 178626 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1545 Mohammed El-Dakkak Physician Interfaith Medical Center IP YES 1346393170 00730323 141621 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1546 JeanGuy Elie Physician Interfaith Medical Center IP YES 1184658346 01697070 172184 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1547 Danilo Enriquez Physician Interfaith Medical Center IP YES 1619947066 01666779 200191 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1548 Valcy Etienne Physician Interfaith Medical Center IP YES 1356324891 01505802 187139 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1549 Joseph Ewa Physician Interfaith Medical Center IP YES 1285808105 01370121 180395 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1550 Ovidio Falcone Physician Interfaith Medical Center IP YES 1477555415 4171 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1551 James Faliszek Physician Interfaith Medical Center IP YES 1467568261 268235 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071552 Law Fu Physician Interfaith Medical Center IP YES 1174872634 272919 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1553 Neena Gadangi Physician Interfaith Medical Center IP YES 1720048069 2248642 217543 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1554 Swati Gandhi Physician Interfaith Medical Center IP YES 1326067190 02780289 238677 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1555 Samantha Gordon Physician Interfaith Medical Center IP YES 1750608030 03448304 251605 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071556 Agnieszka Toth Physician Interfaith Medical Center IP YES 1326264086 3362452 53843 Kings 1536 Bedford Avenue, Brooklyn NY 11216 Brooklyn NY 11216 (718) 613- 7375 1557 Charles Grannum Physician Interfaith Medical Center IP YES 1205904208 02545673 40024 Kings 1536 Bedford Avenue, Brooklyn NY 11216 Brooklyn NY 11216 (718) 613- 7375 1558 Edouard Guillaume Physician Interfaith Medical Center IP YES 1114990355 00857832 147272 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1559 Mario Gustave Physician Interfaith Medical Center IP YES 1184704736 3354294 232004 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1560 Cornelia Ha Physician Interfaith Medical Center IP YES 1245238278 199665 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1561 Fazlul Haque Physician Interfaith Medical Center IP YES 1831279751 00246075 191787 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1562 Nisarul Haque Physician Interfaith Medical Center IP YES 1831279751 00246075 191787 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1563 Gary Herzog Physician Interfaith Medical Center IP YES 1518915941 01561953 186427 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071564 Jason Hodges Physician Interfaith Medical Center IP YES 1306828744 223707 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1565 Mohammed Hoque Physician Interfaith Medical Center IP YES 1518989771 02462224 227398 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1566 Karen Horwitz Physician Interfaith Medical Center IP YES 1790793560 01849389 183152 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071567 Dilruba Hussain Physician Interfaith Medical Center IP YES 1912027947 00658104 144411 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1568 Paul Igbide Physician Interfaith Medical Center IP YES 1912263831 588955 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1569 Aleksandr Ilyayev Physician Interfaith Medical Center IP YES 1962478438 02668555 236023 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1570 Shamah Iqbal Physician Interfaith Medical Center IP YES 1447317755 01476219 156763 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1571 Gerald Jahng Physician Interfaith Medical Center IP YES 1821016049 00225567 A120114 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1572 Ravi Jayanti Physician Interfaith Medical Center IP YES 1457598088 268411 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1573 Max Jean-Gilles Physician Interfaith Medical Center IP YES 1770677353 00945304 165341 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1574 Ayodeji Jolayemi Physician Interfaith Medical Center IP YES 1235490178 271711 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1575 Harjit Kaur Physician Interfaith Medical Center IP YES 1114134152 259979 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1576 Joseph Kavanagh Physician Interfaith Medical Center IP YES 1275614612 242841 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071577 Gopal Kaza Physician Interfaith Medical Center IP YES 1306083936 03346632 3748 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1578 Samrang Kchao Physician Interfaith Medical Center IP YES 1554881071 01162289 169930 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1579 Anukware Ketosugbo Physician Interfaith Medical Center IP YES 1003835000 01036039 147545 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1580 Yevgeniy Khaldarov Physician Interfaith Medical Center IP YES 1710932926 02288571 221405 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1581 Shwan Kim Physician Interfaith Medical Center IP YES 1417901877 214207 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071582 Wally Kopelowitz Physician Interfaith Medical Center IP YES 1639128135 00460297 137132 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1583 George Kovacs Physician Interfaith Medical Center IP YES 1588736995 01837796 207396 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1584 Tomasz Kowacz Physician Interfaith Medical Center IP YES 1063436798 02267527 214508 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1585 Gary Kronfeld Physician Interfaith Medical Center IP YES 1063526630 02710956 152049 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071586 Stella Kwofie Physician Interfaith Medical Center IP YES 1093001638 14863 Kings 1546 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1587 Soon Kwon Physician Interfaith Medical Center IP YES 1194984773 03490562 55964 Kings 1536 Bedford Avenue, Brooklyn NY 11216 Brooklyn NY 11216 (718) 613- 7375 1588 Victor Kwong Physician Interfaith Medical Center IP YES 02436157 02436157 200354 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1589 Gisele Lahens Physician Interfaith Medical Center IP YES 1912057209 6793 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1590 Vito Lapuma Physician Interfaith Medical Center IP YES 1790018059 N006338 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1591 Gladys Laroche Physician Interfaith Medical Center IP YES 1295820629 846882 159564-1 Kings 1546 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1592 Bordes Laurent Physician Interfaith Medical Center IP YES 1902839079 01787333 197503 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1593 Charles Lawrence Physician Interfaith Medical Center IP YES 1952488736 213978 Kings 1546 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1594 Pamela Ledig Physician Interfaith Medical Center IP YES 1710240619 03540205 056016-1 Kings 1536 Bedford Avenue, Brooklyn NY 11216 Brooklyn NY 11216 (718) 613- 7375 1595 Melvin Leeds Physician Interfaith Medical Center IP YES 1679556088 00877963 109477 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071596 Steven Leffler Physician Interfaith Medical Center IP YES 1326056995 02343039 162767 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071597 Robert Limani Physician Interfaith Medical Center IP YES 1922011618 200410 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1598 Michael Lombino Physician Interfaith Medical Center IP YES 1194933911 260805 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1599 Roldy Loremil Physician Interfaith Medical Center IP YES 1851617369 13959 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1600 Todd Lovelace Physician Interfaith Medical Center IP YES 1619917747 261431 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071601 Roderick Lucente Physician Interfaith Medical Center IP YES 1295857191 02771575 52771 Kings 1536 Bedford Avenue, Brooklyn NY 11216 Brooklyn NY 11216 (718) 613- 7375 1602 Edward Lustbader Physician Interfaith Medical Center IP YES 1235204629 34354 Kings 1536 Bedford Avenue, Brooklyn NY 11216 Brooklyn NY 11216 (718) 613- 7375 1603 Jisann Lynch Physician Interfaith Medical Center IP YES 1194823393 9928 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1604 Sonea Mahboob Physician Interfaith Medical Center IP YES 1790063402 02436157 267882 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1605 Tennyson Maliro Physician Interfaith Medical Center IP YES 1740427467 268722 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071606 Victor Mandanas Physician Interfaith Medical Center IP YES 1356413785 02321497 220661 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071607 Mohamed Mansour Physician Interfaith Medical Center IP YES 1003848854 01480762 191343 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1608 Hosneara Masub Physician Interfaith Medical Center IP YES 1477563039 02141702 217560 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1609 Adanela Matos Physician Interfaith Medical Center IP YES 1891728184 319553 134203 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1610 Norman McCulloch Physician Interfaith Medical Center IP YES 1689750580 7174 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1611 Ragini Mehta Physician Interfaith Medical Center IP YES 1023186624 213000 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1612 Urick Michel Physician Interfaith Medical Center IP YES 1780970434 548647 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1613 Wesner Moise Physician Interfaith Medical Center IP YES 1528122314 121660 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1614 David Moon Physician Interfaith Medical Center IP YES 1548213812 248497 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071615 Ki Moon Physician Interfaith Medical Center IP YES 1982644563 132361 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1616 Robert Morley Physician Interfaith Medical Center IP YES 1902998719 249828 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071617 Titus Morton Physician Interfaith Medical Center IP YES 1255407300 796790 149436 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-6800 1618 Hla Myint Physician Interfaith Medical Center IP YES 1639486327 03264326 258201 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1619 Ayyappa MysoreRangaraju Physician Interfaith Medical Center IP YES 1093059925 267554 Kings 1546 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1620 Belinda Narine Physician Interfaith Medical Center IP YES 1750647459 305987 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1621 Albert Ndzengue Physician Interfaith Medical Center IP YES 1851692420 266212 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1622 Sana Nejmeh-Khoury Physician Interfaith Medical Center IP YES 1770638041 02712178 225782 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1623 Peter Nnaemeka Physician Interfaith Medical Center IP YES 1699734921 00100887 145021 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1624 Addy Nnsewo Physician Interfaith Medical Center IP YES 1396806097 03104170 234005 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1625 Michael Novick Physician Interfaith Medical Center IP YES 1346568227 240684 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071626 Adam Oberlander Physician Interfaith Medical Center IP YES 1588825012 243453 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1627 Fadeke Ogunbiyi Physician Interfaith Medical Center IP YES 1972735223 13227 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1628 Theophilus Okeke Physician Interfaith Medical Center IP YES 1083661201 01081209 17457 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1629 Titus Okunlola Physician Interfaith Medical Center IP YES 1699853515 02832231 233011 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1630 Ayotokunbo Olosunde Physician Interfaith Medical Center IP YES 1548407034 255015 Kings 1546 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1631 Ravichand Oodal Physician Interfaith Medical Center IP YES 1679594311 01695481 202533 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1632 Veronica Palacios Physician Interfaith Medical Center IP YES 1336464510 13951 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1633 Joe Parkey Physician Interfaith Medical Center IP YES 1699732925 241769 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071634 Mona Pervil-Ulysse Physician Interfaith Medical Center IP YES 1144215559 01369906 187762 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1635 Rachel Piechowiak Physician Interfaith Medical Center IP YES 1679867212 260214-1 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1636 Revanord Pierre-Louis Physician Interfaith Medical Center IP YES 1053482612 1541313 194861 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1637 Gerald Posner Physician Interfaith Medical Center IP YES 1639273360 00180718 104007 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1638 Roland Purcell Physician Interfaith Medical Center IP YES 1073693594 00968685 157204 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1639 Joseph Quist Physician Interfaith Medical Center IP YES 1053306902 191212 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1640 Dinker (Belle) Rai Physician Interfaith Medical Center IP YES 1881798486 00335626 128729 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1641 Nirmala Rajee Physician Interfaith Medical Center IP YES 1013270040 244691 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1642 Simon Raskin Physician Interfaith Medical Center IP YES 1376526145 02195893 N005608 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1643 Andre Rawle Physician Interfaith Medical Center IP YES 1679805287 13780 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1644 Gaddam Reddy Physician Interfaith Medical Center IP YES 1467591057 02383326 129299 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1645 Zoe Rosal-Arcillas Physician Interfaith Medical Center IP YES 1467501825 00407350 120707 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1646 Amal Saha Physician Interfaith Medical Center IP YES 1003861220 01532778 189842 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1647 Ashok Saha Physician Interfaith Medical Center IP YES 1003861220 01532778 189842 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1648 Mario Saint-Laurent Physician Interfaith Medical Center IP YES 1275657793 782949 155418 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1649 Mirela Sam Physician Interfaith Medical Center IP YES 1285639203 1587686 198399 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1650 Sominder Sandhu Physician Interfaith Medical Center IP YES 1952491623 02268660 182409 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1651 Paul Sarai Physician Interfaith Medical Center IP YES 1811957418 241748 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071652 MarieFrances Schmidt Physician Interfaith Medical Center IP YES 1861584203 01022499 155784 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1653 Leon Serchuk Physician Interfaith Medical Center IP YES 1285617340 00828506 154652 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071654 Sabaratnam Shanmugananthan Physician Interfaith Medical Center IP YES 1902827736 01879001 214905 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1655 Steven Sherman Physician Interfaith Medical Center IP YES 1528159027 00767780 135244-3 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1656 Zewge Shiferaw-Deribe Physician Interfaith Medical Center IP YES 1508846726 02364221 231792 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1657 Michael Shriazi Physician Interfaith Medical Center IP YES 1326289679 251802 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1658 Abhishek Shrivastava Physician Interfaith Medical Center IP YES 1285842096 03113600 253589 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071659 Devendra Shrivastava Physician Interfaith Medical Center IP YES 1952494536 182573 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-6800 1660 Rochelle Sims Physician Interfaith Medical Center IP YES 1871706606 259345 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1661 Supreet Sing Physician Interfaith Medical Center IP YES 1659530921 248530 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1662 Elliot Singer Physician Interfaith Medical Center IP YES 1205954039 98745 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1663 Vadamalayan Sivalingam Physician Interfaith Medical Center IP YES 1982900668 003947-1 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1664 Portia Siwawa Physician Interfaith Medical Center IP YES 1215220488 03369142 266430 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1665 Stacey Smith Physician Interfaith Medical Center IP YES 1396828745 00862015 158414 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1666 Oronde Smith Physician Interfaith Medical Center IP YES 1962427211 221468 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1667 Adeola Sofola Physician Interfaith Medical Center IP YES 1598720047 00859045 158426 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1668 Benjamin Solomowitz Physician Interfaith Medical Center IP YES 1699892760 00891658 37738 Kings 1536 Bedford Avenue, Brooklyn NY 11216 Brooklyn NY 11216 (718) 613- 7375 1669 Lodze Steckman Physician Interfaith Medical Center IP YES 1215257084 03425550 256450 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1670 John Stewart Physician Interfaith Medical Center IP YES 1053367250 263016 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071671 Rosemarie Stiell Physician Interfaith Medical Center IP YES 1609048131 03389397 F335373 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1672 Khandaker Taher Physician Interfaith Medical Center IP YES 1457619736 03509955 004010-1 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1673 Samia Tayab Physician Interfaith Medical Center IP YES 1386716140 01922274 212345 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1674 Anne Thomas-Guillaume Physician Interfaith Medical Center IP YES 1740384783 01627274 184337 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1675 Louis Timothee Physician Interfaith Medical Center IP YES 1831270735 00905697 153556 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1676 Marie Tolete Physician Interfaith Medical Center IP YES 1699822622 1041712 6964714 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1677 David Trauber Physician Interfaith Medical Center IP YES 1558366575 01222619 142630 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1678 Ira Tyler Physician Interfaith Medical Center IP YES 1255438693 146177 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071679 Rakesh Vadde Physician Interfaith Medical Center IP YES 1366680845 03527566 3997 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1680 Parvathy Vasudevan Physician Interfaith Medical Center IP YES 1235203654 01814259 179694 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1681 Ancy Verdier Physician Interfaith Medical Center IP YES 1245478122 03362310 51891 Kings 1536 Bedford Avenue, Brooklyn NY 11216 Brooklyn NY 11216 (718) 613- 7375 1682 Erez Vidan Physician Interfaith Medical Center IP YES 1982818373 03293565 238696 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071683 Erez Vidan Physician Interfaith Medical Center IP YES 1982818373 238696 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1684 Raul Villacob-Roca Physician Interfaith Medical Center IP YES 1427221852 me100523 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1685 Eddy Vincent Physician Interfaith Medical Center IP YES 1750425419 00279869 133188 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1686 Ayesha Waheed Physician Interfaith Medical Center IP YES 1992956494 264733 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071687 Russell Weinstein Physician Interfaith Medical Center IP YES 1992788459 02489027 224598 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071688 Sam Weissman Physician Interfaith Medical Center IP YES 1922083880 1659961 187803 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1689 David Weltman Physician Interfaith Medical Center IP YES 1326021163 01507639 170720 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071690 Jasmine Wickham Physician Interfaith Medical Center IP YES 1538223391 514985 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1691 Robert Wilkins Physician Interfaith Medical Center IP YES 1508840505 143114 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1692 Wilkins Williams Physician Interfaith Medical Center IP YES 1841385770 226203 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1693 Claudia Wilson Physician Interfaith Medical Center IP YES 1205888120 130158 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1694 Martin Wininger Physician Interfaith Medical Center IP YES 1306997648 00956336 94866 Kings 528 Prospect Place, Brooklyn NY 11238 Brooklyn NY 11238 (718) 613-6800 1695 Albert Wright Physician Interfaith Medical Center IP YES 1033137351 250606 216171-1 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1696 Charles Yang Physician Interfaith Medical Center IP YES 1679736706 03168870 243097 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718)613-47071697 Rhodora Yap Physician Interfaith Medical Center IP YES 1619043171 01696079 182098 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1698 Kang Yu Physician Interfaith Medical Center IP YES 1891734992 00734336 133397 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1699 Ali Zaidi Physician Interfaith Medical Center IP YES 1245263409 2491972 229868 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1700 HENRI J. DESROSIERS Physician Interfaith Medical Center IP YES 1487613386 476049-1 KINGS 206 EAST 38TH STREET Brooklyn NY 11203 (718)469-5465 1701 LESLINE EDWARDS Physician Interfaith Medical Center IP YES 1235147711 F333663 KINGS 5594 KINGS HIGHWAY Brooklyn NY 11203 (718)346-8300 1702 GERMAINE SHEPPARD-DURANT Physician Interfaith Medical Center IP YES 1093047821 335375 KINGS 608 RUGBY ROAD Brooklyn NY 11230 (718)859-8961 1703 MARY A. GLANVILLE-DAWKINS Physician Interfaith Medical Center IP YES 1386737567 F333288-1 KINGS 1359 E. 102ND ST Brooklyn NC 11236 (718)241-6192 1704 BOLANLE BELLO Physician Interfaith Medical Center IP YES 1013160613 F401162-1 QUEENS 257-51 149TH ROAD Rosedale NY 11422 (718)723-6158 1705 SHARON BEVERLEY TERRELONGE Physician Interfaith Medical Center IP YES 1912218512 338375 Nassau 33 CLARENDON DRIVE Valley Stream NY 11580 (516)612-2257 1706 URICK MICHEL Physician Interfaith Medical Center IP YES 1780970434 305626 KINGS 1531 EAST 54TH STREET Brooklyn NY 11234 (718)241-1134 1707 VIRGINIA PRYCE Physician Interfaith Medical Center IP YES 1003978289 333005 KINGS 727 EAST 96TH ST Brooklyn NY 11236 (718)345-5305 1708 CHARMAINE DANVERS Physician Interfaith Medical Center IP YES 1245408624 F333287 QUEENS 134-51 241ST STREET Rosedale NY 11422 (718)527-4227 1709 DOREEN ROBINSON Physician Interfaith Medical Center IP YES 1407917602 303961 Nassau 180 DOGWOOD RD Valley Stream NY 11580 (516)825-3026 1710 SVETLANA SIROTA Physician Interfaith Medical Center IP YES 1104991934 011586 KINGS 1676 UNION STREET Brooklyn NY 11213 (718)735-6864 1711 DAVID ROMAN Physician Interfaith Medical Center IP YES 1770704835 002815-1 Nassau 201 WASHINGTON STREET Freeport NY 11520 (516)608-1516 1712 JEAN-BAPTISTE RICHARD Physician Interfaith Medical Center IP YES 1538247077 10406 KINGS 707 EAST 78 STREET Brooklyn NY 11236 (646)245-9125 1713 HENRI G. PIERRE Physician Interfaith Medical Center IP YES 1730257650 004113 KINGS 1417 EAST 101ST ST Brooklyn NY 11236 (718)755-7728 1714 Sara Banerjee Physician Interfaith Medical Center IP YES 1194928416 268446 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1715 Michael Bloss Physician Interfaith Medical Center IP YES 1801854732 248478 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1716 Bruce Campbell Physician Interfaith Medical Center IP YES 1780666883 01749802 192141 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1717 Jeffrey Carlson Physician Interfaith Medical Center IP YES 1538133095 261231 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1718 Albert Chang Physician Interfaith Medical Center IP YES 1083869226 03119257 252856 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1719 Herman Del Arca Physician Interfaith Medical Center IP YES 1073500518 231705 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1720 Reginald Denis Physician Interfaith Medical Center IP YES 1699984682 02881276 243694 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1721 Jean-Paul Dym Physician Interfaith Medical Center IP YES 1376741157 226375 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1722 James Faliszek Physician Interfaith Medical Center IP YES 1467568261 268235 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1723 Samantha Gordon Physician Interfaith Medical Center IP YES 1750608030 03448304 251605 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1724 Gary Herzog Physician Interfaith Medical Center IP YES 1518915941 01561953 186427 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1725 Karen Horwitz Physician Interfaith Medical Center IP YES 1790793560 01849389 183152 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1726 Joseph Kavanagh Physician Interfaith Medical Center IP YES 1275614612 242841 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1727 Shwan Kim Physician Interfaith Medical Center IP YES 1417901877 214207 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1728 Gary Kronfeld Physician Interfaith Medical Center IP YES 1063526630 02710956 152049 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1729 Melvin Leeds Physician Interfaith Medical Center IP YES 1679556088 00877963 109477 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1730 Steven Leffler Physician Interfaith Medical Center IP YES 1326056995 02343039 162767 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1731 Todd Lovelace Physician Interfaith Medical Center IP YES 1619917747 261431 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1732 Tennyson Maliro Physician Interfaith Medical Center IP YES 1740427467 268722 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1733 Victor Mandanas Physician Interfaith Medical Center IP YES 1356413785 02321497 220661 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1734 Robert Morley Physician Interfaith Medical Center IP YES 1902998719 249828 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1735 Michael Novick Physician Interfaith Medical Center IP YES 1346568227 240684 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1736 Joe Parkey Physician Interfaith Medical Center IP YES 1699732925 241769 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1737 Paul Sarai Physician Interfaith Medical Center IP YES 1811957418 241748 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1738 Leon Serchuk Physician Interfaith Medical Center IP YES 1285617340 00828506 154652 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1739 Abhishek Shrivastava Physician Interfaith Medical Center IP YES 1285842096 03113600 253589 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1740 John Stewart Physician Interfaith Medical Center IP YES 1053367250 263016 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1741 Ira Tyler Physician Interfaith Medical Center IP YES 1255438693 146177 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1742 Erez Vidan Physician Interfaith Medical Center IP YES 1982818373 03293565 238696 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1743 Ayesha Waheed Physician Interfaith Medical Center IP YES 1992956494 264733 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1744 Russell Weinstein Physician Interfaith Medical Center IP YES 1992788459 02489027 224598 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1745 David Weltman Physician Interfaith Medical Center IP YES 1326021163 01507639 170720 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1746 Charles Yang Physician Interfaith Medical Center IP YES 1679736706 03168870 243097 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1747 Imtiaz Ahmad Physician Interfaith Medical Center IP YES 1962494997 243670 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1748 Hamid Alam Physician Interfaith Medical Center IP YES 1285659649 853551 240456 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1749 Edmond Balakhane Physician Interfaith Medical Center IP YES 1992787121 203666 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1750 Marsha Jane Bitter Physician Interfaith Medical Center IP YES 1124000674 146892 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1751 Cornelia Ha Physician Interfaith Medical Center IP YES 1245238278 199665 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1752 Harjit Kaur Physician Interfaith Medical Center IP YES 1114134152 259979 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1753 Jason Hodges Physician Interfaith Medical Center IP YES 1306828744 223707 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1754 Robert Limani Physician Interfaith Medical Center IP YES 1922011618 200410 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1755 Michael Lombino Physician Interfaith Medical Center IP YES 1194933911 260805 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1756 Adam Oberlander Physician Interfaith Medical Center IP YES 1588825012 243453 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1757 Rachel Piechowiak Physician Interfaith Medical Center IP YES 1679867212 260214-1 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1758 Michael Shriazi Physician Interfaith Medical Center IP YES 1326289679 251802 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1759 Supreet Sing Physician Interfaith Medical Center IP YES 1659530921 248530 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1760 Elliot Singer Physician Interfaith Medical Center IP YES 1205954039 98745 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1761 Erez Vidan Physician Interfaith Medical Center IP YES 1982818373 238696 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1762 Robert Wilkins Physician Interfaith Medical Center IP YES 1508840505 143114 Kings 1545 Atlantic Avenue, Brooklyn NY 11213 Brooklyn NY 11213 (718) 613-4000 1763 More Physicians To Be Added17641765176617671768






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1769177017711772177317741775177617771778177917801781178217831784178517861787178817891790179117921793179417951796179717981799180018011802180318041805180618071808180918101811181218131814181518161817181818191820






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1821182218231824182518261827182818291830183118321833183418351836183718381839184018411842184318441845184618471848184918501851185218531854185518561857185818591860186118621863186418651866186718681869187018711872






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1873187418751876187718781879188018811882188318841885188618871888188918901891189218931894189518961897189818991900190119021903190419051906190719081909191019111912191319141915191619171918191919201921192219231924






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

1925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976






1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




SN Qualified (Y/N)

197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000



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[email protected]

[email protected]


[email protected]

[email protected]

[email protected]

[email protected]@[email protected]@[email protected]@bmsfhc.org



16

Email

[email protected]@[email protected]@[email protected]@[email protected]@[email protected]


[email protected]


[email protected]

[email protected]

[email protected]





[email protected]



[email protected]@med.cornell.edu


[email protected]

[email protected]@columbia.edu




16

Email


[email protected]@[email protected]@[email protected]@msn.com

[email protected]


[email protected]

[email protected]



[email protected]@[email protected]@gmail.com

[email protected]

[email protected]


[email protected]

[email protected]

[email protected]

[email protected]

[email protected]



16

Email

[email protected]@[email protected]@gmail.com

[email protected]

[email protected]

[email protected]@msn.com

Sarath Reddy [email protected]




[email protected]



[email protected]

[email protected]@buenavidacenter.org

[email protected]

[email protected]

[email protected]

[email protected]


[email protected]



16

Email






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16

Email

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[email protected]

[email protected]


[email protected]

[email protected]




[email protected]

[email protected]


[email protected]@nyu.edu

[email protected]


[email protected]



16

Email



[email protected]

[email protected]

[email protected]@bsfhc.org












[email protected]



16

Email



[email protected]


DSRIP Project Design Grant Application Section 2.4 Pharmacy List

2.4) Pharmacy - Contact Information

1 2 3 4

Pharmacy Name NPI MMIS

1 Kings Park Slope Inc NO 1942311329 10149422 Kings Drug and Surgical Inc NO 1740226109 16716093456789

10111213141516171819202122232425262728293031323334353637

SN Qualified (Y/N)




1 2 3 4

Pharmacy Name NPI MMISSN Qualified (Y/N)

38394041424344454647484950515253545556575859606162636465666768697071727374




1 2 3 4


75767778798081828384858687888990919293949596979899

100101102103104105106107108109110111




1 2 3 4


112113114115116117118119120121122123124125126127128129130131132133134135136137138139140141142143144145146147148




1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


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1 2 3 4


1037103810391040104110421043104410451046104710481049105010511052105310541055105610571058105910601061106210631064106510661067106810691070107110721073




1 2 3 4


1074107510761077107810791080108110821083108410851086108710881089109010911092109310941095109610971098109911001101110211031104110511061107110811091110




1 2 3 4


1111111211131114111511161117111811191120112111221123112411251126112711281129113011311132113311341135113611371138113911401141114211431144114511461147




1 2 3 4


1148114911501151115211531154115511561157115811591160116111621163116411651166116711681169117011711172117311741175117611771178117911801181118211831184




1 2 3 4


1185118611871188118911901191119211931194119511961197119811991200120112021203120412051206120712081209121012111212121312141215121612171218121912201221




1 2 3 4


1222122312241225122612271228122912301231123212331234123512361237123812391240124112421243124412451246124712481249125012511252125312541255125612571258




1 2 3 4


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1 2 3 4


1296129712981299130013011302130313041305130613071308130913101311131213131314131513161317131813191320132113221323132413251326132713281329133013311332




1 2 3 4


1333133413351336133713381339134013411342134313441345134613471348134913501351135213531354135513561357135813591360136113621363136413651366136713681369




1 2 3 4


1370137113721373137413751376137713781379138013811382138313841385138613871388138913901391139213931394139513961397139813991400140114021403140414051406




1 2 3 4


1407140814091410141114121413141414151416141714181419142014211422142314241425142614271428142914301431143214331434143514361437143814391440144114421443




1 2 3 4


1444144514461447144814491450145114521453145414551456145714581459146014611462146314641465146614671468146914701471147214731474147514761477147814791480




1 2 3 4


1481148214831484148514861487148814891490149114921493149414951496149714981499150015011502150315041505150615071508150915101511151215131514151515161517




1 2 3 4


1518151915201521152215231524152515261527152815291530153115321533153415351536153715381539154015411542154315441545154615471548154915501551155215531554




1 2 3 4


1555155615571558155915601561156215631564156515661567156815691570157115721573157415751576157715781579158015811582158315841585158615871588158915901591




1 2 3 4


1592159315941595159615971598159916001601160216031604160516061607160816091610161116121613161416151616161716181619162016211622162316241625162616271628




1 2 3 4


1629163016311632163316341635163616371638163916401641164216431644164516461647164816491650165116521653165416551656165716581659166016611662166316641665




1 2 3 4


1666166716681669167016711672167316741675167616771678167916801681168216831684168516861687168816891690169116921693169416951696169716981699170017011702




1 2 3 4


1703170417051706170717081709171017111712171317141715171617171718171917201721172217231724172517261727172817291730173117321733173417351736173717381739




1 2 3 4


1740174117421743174417451746174717481749175017511752175317541755175617571758175917601761176217631764176517661767176817691770177117721773177417751776




1 2 3 4


1777177817791780178117821783178417851786178717881789179017911792179317941795179617971798179918001801180218031804180518061807180818091810181118121813




1 2 3 4


1814181518161817181818191820182118221823182418251826182718281829183018311832183318341835183618371838183918401841184218431844184518461847184818491850




1 2 3 4


1851185218531854185518561857185818591860186118621863186418651866186718681869187018711872187318741875187618771878187918801881188218831884188518861887




1 2 3 4


1888188918901891189218931894189518961897189818991900190119021903190419051906190719081909191019111912191319141915191619171918191919201921192219231924




1 2 3 4


1925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961




1 2 3 4


1962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998




1 2 3 4


1999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035




1 2 3 4


2036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072




1 2 3 4


2073207420752076207720782079208020812082208320842085208620872088208920902091209220932094209520962097209820992100210121022103210421052106210721082109




1 2 3 4


2110211121122113211421152116211721182119212021212122212321242125212621272128212921302131213221332134213521362137213821392140214121422143214421452146




1 2 3 4


2147214821492150215121522153215421552156215721582159216021612162216321642165216621672168216921702171217221732174217521762177217821792180218121822183




1 2 3 4


2184218521862187218821892190219121922193219421952196219721982199220022012202220322042205220622072208220922102211221222132214221522162217221822192220




1 2 3 4


2221222222232224222522262227222822292230223122322233223422352236223722382239224022412242224322442245224622472248224922502251225222532254225522562257




1 2 3 4


2258225922602261226222632264226522662267226822692270227122722273227422752276227722782279228022812282228322842285228622872288228922902291229222932294




1 2 3 4


2295229622972298229923002301230223032304230523062307230823092310231123122313231423152316231723182319232023212322232323242325232623272328232923302331




1 2 3 4


2332233323342335233623372338233923402341234223432344234523462347234823492350235123522353235423552356235723582359236023612362236323642365236623672368




1 2 3 4


2369237023712372237323742375237623772378237923802381238223832384238523862387238823892390239123922393239423952396239723982399240024012402240324042405




1 2 3 4


2406240724082409241024112412241324142415241624172418241924202421242224232424242524262427242824292430243124322433243424352436243724382439244024412442




1 2 3 4


2443244424452446244724482449245024512452245324542455245624572458245924602461246224632464246524662467246824692470247124722473247424752476247724782479




1 2 3 4


2480248124822483248424852486248724882489249024912492249324942495249624972498249925002501250225032504250525062507250825092510251125122513251425152516




1 2 3 4


2517251825192520252125222523252425252526252725282529253025312532253325342535253625372538253925402541254225432544254525462547254825492550255125522553




1 2 3 4


2554255525562557255825592560256125622563256425652566256725682569257025712572257325742575257625772578257925802581258225832584258525862587258825892590




1 2 3 4


2591259225932594259525962597259825992600260126022603260426052606260726082609261026112612261326142615261626172618261926202621262226232624262526262627




1 2 3 4


2628262926302631263226332634263526362637263826392640264126422643264426452646264726482649265026512652265326542655265626572658265926602661266226632664




1 2 3 4


2665266626672668266926702671267226732674267526762677267826792680268126822683268426852686268726882689269026912692269326942695269626972698269927002701




1 2 3 4


2702270327042705270627072708270927102711271227132714271527162717271827192720272127222723272427252726272727282729273027312732273327342735273627372738




1 2 3 4


2739274027412742274327442745274627472748274927502751275227532754275527562757275827592760276127622763276427652766276727682769277027712772277327742775




1 2 3 4


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1 2 3 4


2813281428152816281728182819282028212822282328242825282628272828282928302831283228332834283528362837283828392840284128422843284428452846284728482849




1 2 3 4


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1 2 3 4


2887288828892890289128922893289428952896289728982899290029012902290329042905290629072908290929102911291229132914291529162917291829192920292129222923




1 2 3 4


2924292529262927292829292930293129322933293429352936293729382939294029412942294329442945294629472948294929502951295229532954295529562957295829592960




1 2 3 4


2961296229632964296529662967296829692970297129722973297429752976297729782979298029812982298329842985298629872988298929902991299229932994299529962997




1 2 3 4


299829993000




Pharmacy List

5 6 7 8 10

License # County Address City State

Kings 375 Flatbush Avenue Brooklyn NYKings 492 Clarkson Avenue Brooklyn NY




Pharmacy List

5 6 7 8 10

License # County Address City State




Pharmacy List

11 12 13 14 15

Zip Contact Name Phone # Extension Email

11238 Dmitry Vagman, RPh 718-230-3535 [email protected] Roy Grief, RPh 718-363-3300 [email protected]




Pharmacy List

11 12 13 14 15

Zip Contact Name Phone # Extension Email


NYS DOH DSRIP_Project Design Grant Application Section 10 Section 10 - Project Advisory Committee (PAC)

Section 10Project Advisory Committee - PAC

10.1) How will the Project Advisory Committee assist the emerging Performing Provider System in the development of its DSRIP Project Plan? (Restricted to 4500 characters)Characters used: 4280

Each emerging Performing Provider System (PPS) is required to form a Project Advisory Committee (PAC). The PAC will advise emerging Performing Provider Systems on all elements of their DSRIP Project Plans and should include representation from each of the emerging PPS partners as well as workers and/or relevant unions. Unless an alternative structure is being proposed. Project Advisory Committee representatives should be determined using the following process:

1. Organizational representatives:a. Emerging PPS partners with more than 50 employees are required to have an organizational (managerial) representative participate in the PAC.b. Emerging PPS partners with less than 50 employees have the option of selecting an organizational (managerial) representative to participate in the PAC.

2. Worker representatives:a. Partner organizations that are not unionized and have over 50 employees must develop a process to elect a worker (non-managerial employee) representative to participate in the PAC. b. For non-unionized partner organizations with less than 50 employees, the employees have the option of electing a worker (non-managerial employee) representative to participate in the PAC if they so choose.

3. Union Representatives:a. Partner organizations that are unionized and have over 50 employees must designate a union representative to participate in the PAC. If a particular union represents workers from multiple emerging PPS partners, one representative from that union is sufficient to satisfy PAC requirements. b. For unionized partner organizations with less than 50 employees, the union has the option of designating a union representative to participate in the PAC if they so choose.

This PPS’ Project Advisory Committee (PAC) will serve as an advisory entity within the PPS during both the design and implementation phases. There are no set maximum/minimum number of members and will include community stakeholders. Preliminarily, the PAC will invite prominent members of the local clergy, the Borough President’s Office, Housing Agency Representatives (NYCHA), and others. Collectively, the role of the Project Advisory Committee will be to offer recommendations and offer feedback on the PPS’ initiatives related to each of the projects. They will be contributing best practice ideas on care delivery transformation.

Members of the PAC will be involved in the various facets of developing the PPS’ DSRIP project plan. They will then be directly engaged in the development of oversight of the project plan while acting as community ambassadors and change agents in support of the DSRIP implementation plan within their respective organizations. Participation in the PAC is expected to be substantive and meaningful. Subcommittees and cross-committee assignments from the PAC will come in the form of clinical project committees and cross-functional committees. Project committees will be formed around the selected projects (as outlined in Section 4 of this application). Preliminarily, there will be ten project committees each with the goal of reducing unnecessary acute care utilization while improving the quality of healthcare services provided across the PPS.

Additionally, there will be cross-functional/support committees including areas including capital, finance/funds flow, IT, insurance/data, workforce retraining, patient engagement, collaborations, communication, application, and research. These support committees may be cross-populated with PAC members to streamline PAC input. The Project Advisory Committee will meet at least once a month during the design phase and at least quarterly during the implementation phase. Subcommittees formed around projects or cross-functional/support functions will meet more frequently and as necessary to accomplish their objectives during the design phase.One Brooklyn Health’s Project Advisory Committee (PAC) will serve as an advisory entity within the PPS during both the design and implementation phases. There are no set maximum/minimum number of members and will include community stakeholders. Preliminarily, the PAC will invite prominent members of the local clergy, the Borough President’s Office, Housing Agency Representatives (NYCHA), and others. Collectively, the role of the Project Advisory Committee will be to offer recommendations and offer feedback on the PPS’ initiatives related to each of the projects. They will be contributing best practice ideas on care delivery transformation.


Additionally, there will be cross-functional/support committees including areas including capital, finance/funds flow, IT, insurance/data, workforce retraining, patient engagement, collaborations, communication, application, and research. These support committees may be cross-populated with PAC members to streamline PAC input. The Project Advisory Committee will meet at least once a month during the design phase and at least quarterly during the implementation phase. Subcommittees formed around projects or cross-functional/support functions will meet more frequently and as necessary to accomplish their objectives during the design phase.



This PPS’ Project Advisory Committee (PAC) will serve as an advisory entity within the PPS during both the design and implementation phases. There are no set maximum/minimum number of members and will include community stakeholders. Preliminarily, the PAC will invite prominent members of the local clergy, the Borough President’s Office, Housing Agency Representatives (NYCHA), and others. Collectively, the role of the Project Advisory Committee will be to offer recommendations and offer feedback on the PPS’ initiatives related to each of the projects. They will be contributing best practice ideas on care delivery transformation.


Additionally, there will be cross-functional/support committees including areas including capital, finance/funds flow, IT, insurance/data, workforce retraining, patient engagement, collaborations, communication, application, and research. These support committees may be cross-populated with PAC members to streamline PAC input. The Project Advisory Committee will meet at least once a month during the design phase and at least quarterly during the implementation phase. Subcommittees formed around projects or cross-functional/support functions will meet more frequently and as necessary to accomplish their objectives during the design phase.One Brooklyn Health’s Project Advisory Committee (PAC) will serve as an advisory entity within the PPS during both the design and implementation phases. There are no set maximum/minimum number of members and will include community stakeholders. Preliminarily, the PAC will invite prominent members of the local clergy, the Borough President’s Office, Housing Agency Representatives (NYCHA), and others. Collectively, the role of the Project Advisory Committee will be to offer recommendations and offer feedback on the PPS’ initiatives related to each of the projects. They will be contributing best practice ideas on care delivery transformation.


Additionally, there will be cross-functional/support committees including areas including capital, finance/funds flow, IT, insurance/data, workforce retraining, patient engagement, collaborations, communication, application, and research. These support committees may be cross-populated with PAC members to streamline PAC input. The Project Advisory Committee will meet at least once a month during the design phase and at least quarterly during the implementation phase. Subcommittees formed around projects or cross-functional/support functions will meet more frequently and as necessary to accomplish their objectives during the design phase.



Flexibility in the Project Advisory Committee (Q's 10.2 & 10.3)

10.2) Are you proposing an alternative structure for your Project Advisory Committee? Yes

If you answered "Yes" then:

- Answer question 10.3If you answered "No", then please skip 10.3

10.3) Please give an explanation of how your emerging PPS will be structuring your Project Advisory Committee? (Restricted to 5000 characters)~ See instructions for further clarification Characters used: 704

^ The proposed alternative structure must still represent all key parties(Partner Organization/Union/Worker representatives) within the PPS.

For an emerging Performing Provider System with over 20 partnering organizations, qualifying PPS may propose an alternative PAC structure that will allow for a leaner committee as long as the proposed structure is still representative of all key parties within the PPS.

- Your emerging PPS must contain over 20 partnering organizations

Because of the size of the PPS and the need to maximally but fairly represent all perspectives and voices without unduly burdening smaller organizations, an alternative structure must be implemented. Organizations smaller than 50 employees may not be able to afford dispatching an employee to serve as an active representative of the organization’s workers, unions, and/or management. Smaller organizations may limit PAC participation to a single person, who may represent multiple smaller organizations of the same type. With this exception, all other stipulations of the organization and composition of the PAC as set forth by the New York State Department of Health will be implemented as suggested.



^ Any alternative proposal must be approved by the state during the DSRIP design Grant application process.



10.4)List all the worker representatives, union representatives and Performing Provider System partner organization representatives that will be part of the emerging Performing Provider Systems Project Advisory Committee.~ Please see instructions for clarification

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Name Partner Organization Name *Union Organization NamePierre-Andre Devaud Partner Organization Representative Brooklyn Chamber of Commerce

Justin Frazer Partner Organization Representative HealthPlus AmerigroupDr. John Delf Partner Organization Representative Visiting Nurse Service of New York

Aaron Kaufman Partner Organization Representative Atrium Center for Rehabilitation and NursingPatrick Wormser Partner Organization Representative Health Insurance Plan of Greater New York

Carol Vargas Partner Organization Representative New York Methodist HospitalDr. Karen Benker Partner Organization Representative SUNY Downstate Medical CenterDr. Mathew Foley Union Representative SUNY Downstate Medical Center United University Professors (UUP)

Rowena Blackman-Stroud Union Representative SUNY Downstate Medical Center United University Professors (UUP)Althea Green-Pruitt Union Representative SUNY Downstate Medical Center California School Employees Association NY (CSEA)Don Morgenstern Union Representative SUNY Downstate Medical Center New York State Public Employees Federation (PEF)

Gale Baptiste Union Representative SUNY Downstate Medical Center New York State Public Employees Federation (PEF)Stephanie Friot Partner Organization Representative Diaspora Community ServicesKurt H. Leggard Partner Organization Representative Personal-Touch Home Care of NY, Inc.Katia Guillaume Union Representative Personal-Touch Home Care of NY, Inc. 1199

Charlene Lindsay-Jorgensen Partner Organization Representative Kingsboro Psychiatric CenterLeah Harrison Union Representative Kingsboro Psychiatric Center CSEA/PEF/NYSCOBA

Eric Kalt Partner Organization Representative Crown Nursing and Rehabilitation CenterAgatha Marius Springer Union Representative Crown Nursing and Rehabilitation Center

Alissa Wassung Partner Organization Representative God's Love We DeliverDorella Walters Worker Representative God's Love We Deliver

Elena Lowe Partner Organization Representative Integra Managed Care, IncCarlene Jean-Baptiste Worker Representative Integra Managed Care, Inc

Cameron George Partner Organization Representative Personal Touch Home Aides of New York, Inc.Shabse Oberlender Partner Organization Representative Ditmas Park Care CenterYekusiel Drezdner Union Representative Ditmas Park Care Center

Dr. Henry Chen Partner Organization Representative Chinese Community Accountable Care OrganizationJosephine Wu Worker Representative Chinese Community Accountable Care Organization

Dr. Henry Chen Partner Organization Representative Eastern Chienese American Physician IPAAlex Chan Worker Representative Eastern Chienese American Physician IPATony Lewis Partner Organization Representative Cobble Hill LifeCareJulia Gittens Union Representative Cobble Hill LifeCare 1199

Chantal Hamlin Partner Organization Representative Brooklyn JubileeRuth C. Browne Partner Organization Representative Arthur Ashe Institute for Urban Health

Dr. Marilyn Fraser-White Worker Representative Arthur Ashe Institute for Urban HealthRoy Greif Partner Organization Representative Kings Drug and Surgical Inc.

Dmitry Vagman Partner Organization Representative Kings Park Slope, Inc.Dr Pascale Kersaint Partner Organization Representative Bedford Stuyvesant Family Health Center

Jack Murray Worker Representative Bedford Stuyvesant Family Health Center Ngozi Moses Partner Organization Representative Brooklyn Perinatal Network, inc.

Marco Damiani Partner Organization Representative Young Adult Institute, Inc. Carolyn Driscoll Worker Representative Young Adult Institute, Inc.

Navneet Kathuria Partner Organization Representative Premier Healthcare, Inc.

Partner Organization Representative/Union Representative*/Worker Representative



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Name Partner Organization Name *Union Organization NamePartner Organization Representative/Union

Representative*/Worker RepresentativeMagnus Thompson Worker Representative Premier Healthcare, Inc.

Morgan McCray Partner Organization Representative The Allure GroupAimey Parris Worker Representative The Allure Group

Harvey Lawrence Partner Organization Representative Brownsville Community Dev. Corp.Genese Morgan Worker Representative Brownsville Community Dev. Corp.

Nicole Griffin Union Representative Brownsville Community Dev. Corp.John Diaz-Chermack Partner Organization Representative Hospice of NY, LLC

Martha Heller, RN, CHPN Worker Representative Hospice of NY, LLCWendy Stark Partner Organization Representative Lutheran Family Health Centers Samuel Sierra Union Representative Lutheran Family Health Centers 1199; UFT; SPSOA

Joan Carney- Clarke Partner Organization Representative The Brooklyn Hospital CenterLeon Crooks Union Representative The Brooklyn Hospital Center 1199 SEIU; Local 3; Local 971/550Todd Pinkus Partner Organization Representative NEW York Integrated Network, IPA

David Greenberg Partner Organization Representative Boro Park Center for Rehab & Health CareLloyd Maul Union Representative Boro Park Center for Rehab & Health Care 1199 SEIU

Stacey Hightower Partner Organization Representative Interfaith Medical CenterAri Moma Union Representative Interfaith Medical Center 1199; NYSNA

Shabse Oberlender Partner Organization Representative Lansante Community Services, Inc. Shalom Lerner Partner Organization Representative Bushwick Center for Rehab and HealthcareLeroy Bradford Union Representative Bushwick Center for Rehab and HealthcareJames R. Porter Partner Organization Representative The Brookdale Hospital Medical Center

Jacqueline Barley Worker Representative The Brookdale Hospital Medical CenterSol Blumenfield Partner Organization Representative Brooklyn Center for Rehab & Residential Health CareMary J. Zagajeski Partner Organization Representative Dominican Sisters Family Health Services

Mary Jean McKeveny Worker Representative Dominican Sisters Family Health ServicesCecelia Zuckerman Partner Organization Representative New York Congregational Nursing Center

Samuel Feuer Partner Organization Representative Oxford Nursing Home 1199 SEIUWilliam Sammis Partner Organization Representative CRVI- Crystal Run Village, Inc. Sam Laganaro Worker Representative CRVI- Crystal Run Village, Inc.

Igal Jellinek Partner Organization Representative Council of Senior Centers and Services of NYCDr. Linda Brady Partner Organization Representative Kingsbrook Jewish Medical Center

Dawn Rose Union Representative Kingsbrook Jewish Medical Center 1199;NYSNADiane Neptune Worker Representative Kingsbrook Jewish Medical Center 1199;NYNSADr. Linda Brady Partner Organization Representative Rutland Nursing Home Diane Neptune Worker Representative Rutland Nursing Home 1199;NYNSA

Dawn Rose Union Representative Rutland Nursing Home 1199;NYNSASelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect One



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Representative*/Worker RepresentativeSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect One



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Representative*/Worker RepresentativeSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect OneSelect One

INDEX SCOREDomain 2 System Transformation Projects

2A. Create Integrated Delivery Systems (required)2B. Implementation of care coordination and transitional care programs2C. Connecting system

Select One2.A.I Create Integrated Delivery Systems that are focused on Evidence Based Medicine / Population Health Management 56

2.A.II Increase certification of primary care practitioners with PCMH certification and/or Advanced Primary Care Models (as developed under the New York State Health Innovation Plan (SHIP)) 372.A.III Health Home At-Risk Intervention Program –Proactive management of higher risk patients not currently eligible for Health Homes through access to high quality primary care and support services. 462.A.IV Create a medical village using existing hospital infrastructure 542.A.V Create a medical village/ alternative housing using existing nursing home 42

Select One2.B.I Ambulatory ICUs 36

2.B.II Development of co-located primary care services in the emergency department (ED) 402.B.III ED care triage for at-risk populations 432.B.IV Care transitions intervention model to reduce 30 day readmissions for chronic health conditions 432.B.V Care transitions intervention for skilled nursing facility residents 41

2.B.VI Transitional supportive housing services 472.B.VII Implementing the INTERACT project (inpatient transfer avoidance program for SNF) 41

2.B.VIII Hospital-Home Care Collaboration Solutions 452.B.IX Implementation of observational programs in hospitals 36

2.C.I Development of community-based health navigation services 372.C.II Expand usage of telemedicine in underserved areas to provide access to otherwise scarce services 31

Select One2.A.I Create Integrated Delivery Systems that are focused on Evidence Based Medicine / Population Health Management 56

2.A.II Increase certification of primary care practitioners with PCMH certification and/or Advanced Primary Care Models (as developed under the New York State Health Innovation Plan (SHIP)) 372.A.III Health Home At-Risk Intervention Program –Proactive management of higher risk patients not currently eligible for Health Homes through access to high quality primary care and support services. 462.A.IV Create a medical village using existing hospital infrastructure 542.A.V Create a medical village/ alternative housing using existing nursing home 422.B.I Ambulatory ICUs 36

2.B.II Development of co-located primary care services in the emergency department (ED) 402.B.III ED care triage for at-risk populations 432.B.IV Care transitions intervention model to reduce 30 day readmissions for chronic health conditions 432.B.V Care transitions intervention for skilled nursing facility residents 41

2.B.VI Transitional supportive housing services 472.B.VII Implementing the INTERACT project (inpatient transfer avoidance program for SNF) 41

2.B.VIII Hospital-Home Care Collaboration Solutions 452.B.IX Implementation of observational programs in hospitals 36

2.C.I Development of community-based health navigation services 372.C.II Expand usage of telemedicine in underserved areas to provide access to otherwise scarce services 31

Domain 3 Clinical Improvement Projects3A. Behavioral Health (Required)3B. Cardiovascular Health3C. Diabetes Care3D. Asthma3E. HIV3F. Perinatal3G. Palliative Care3H. Renal Care

Select One3.A.I Integration of primary care services and behavioral health 39

3.A.II Behavioral health community crisis stabilization services 373.A.III Implementation of evidence based medication adherence program (MAP) in community based sites for behavioral health medication compliance 293.A.IV Development of withdrawal management (ambulatory detoxification) capabilities within communities 363.A.V Behavioral Interventions Paradigm in Nursing Homes (BIPNH) 403.B.I Evidence based strategies for disease management in high risk/affected populations (adult only) 30

3.B.II Implementation of evidence-based strategies in the community to address chronic disease -- primary and secondary prevention projects (adult only) 263.CI Evidence-based strategies for disease management in high risk/affected populations (adults only) 30

3.CII Implementation of evidence-based strategies in the community to address chronic disease – primary and secondary prevention projects (adults only) 263.DI Development of evidence-based medication adherence programs (MAP) in community settings –asthma medication 28

3.DII Expansion of asthma home-based self-management program 313.DIII Evidence based medicine guidelines for asthma management 31

3E.I Comprehensive Strategy to decrease HIV/AIDS transmission to reduce avoidable hospitalizations – development of a Center of Excellence for management of HIV/AIDS 283F.I Increase support programs for maternal & child health (including high risk pregnancies) (Example: Nurse-Family Partnership) 293.GI IHI “Conversation Ready” model 29

3.GII Integration of palliative care into medical homes 223.GIII Integration of palliative care into nursing homes 25

3H.I Specialized Medical Home from Chronic Renal Failure 29

Domain 4 Population-Wide Projects4A. Promote Mental Health and Prevent Substance Abuse (MHSA)4B. Prevent Chronic Diseases4C. Prevent HIV and STD's4D. Promote Healthy Women, Infants and Children

Select One4.A.I Promote mental, emotional and behavioral (MEB) well-being in communities 23

4.A.II Prevent Substance Abuse and other Mental Emotional Behavioral Disorders 204.A.III Strengthen Mental Health and Substance Abuse Infrastructure across Systems 20

4.B.I Promote tobacco use cessation, especially among low SES populations and those with poor mental health 234.B.II Increase Access to High Quality Chronic Disease Preventive Care and Management in Both Clinical and Community Settings (Note: This project targets chronic diseases that are not included in domain 3.b., such as cancer) 17

4.CI Decrease HIV morbidity 194.CII Increase early access to, and retention in, HIV care 19

4.CIII Decrease STD morbidity 154.CIV Decrease HIV and STD disparities 18

4.DI Reduce premature births 24

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