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Get NY IS-1 2013-2024

SICIANS Designation as an Impartial Specialist is for a five (5) year term. Complete both sides of this application. All entries are to be typewritten or printed clearly. Return the completed form to the Workers' Compensation Board, Medical Director's Office, Riverview Center, 150 Broadway - Suite 195, Menands, NY 12204. If you have any questions regarding the completion of this form, you may contact us at the above noted address or call 1-800-781-2362. A physician seeking designation as an Impa.

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