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S UPREME COURT OF TH18 S TATE OF NEW YORK COUNTY OF NEW YORK DANEL H. W ENER, against P la intiff, 4- nv! ndtzx No.: 805350/20 DEMAND FGR AUTHOR ZATONS S AMER J ABER, m.d_, RGEL DERMATOLOGY, PLLC a nd S CHWEGER DERMATOLOGY GROUP, LLC, Defendants, -X P LEAS E TAKE NOTC E, th a t defendant, S AMER J AB ER, M. D, b y h is a tto m e y s, duly e xe cute d a nd a cknowle dge d writte n, HiPAA compiia nt a uthoriza tions pe rmitting the unde rsigne d to obta in re cords ma inta ine d by the following he a lthca re provide rs/fa cilitie s a s to pla intiff: 1. Rige l De rma tology, PLLC, 35 Ea st 35"' S tre e t, NY, NY 10016 2. S chwe ige r De rma tology Group, LLC, 110 Ea st 55[ \S tre e t, NY, NY 10022 3. Dermatology Associates, PA of the Palm Beaches, Christina Lampuri, MD. 120A Butler Street, West Palm Beach, FL 33407 (Arons and Medical Records Azltlzorization) 4. De rmpa th Dia gnostics, 895S W 308' Ave nue, S uite 101, Pompa no Be a ch, FL33069 5. Richard L. Shapiro, m.d., 160 East 34'*' Street, 4"' Floor, NY, NY 10016 (Arons and Medical Records Authorization) l 6. S ha ne Me e ha n, M.D., De rma topa thology S e ction, NYU La ngone Me dica l Ce nte r 240 Ea st 38"' S tre e t, 11"' Floor, NY, NY 10016, (212) 263-7250 7. NYU Hos pita l Ce nte r 8. Anna C. Pa vlick, DO 9. Dr. Jedd D. Wolchok (Aroz..gfum'Medical Records Auflzorizatiorz) 10. Memorial Soa11-Kettering Cancer Center LEGAL/l07257097.v
ll. Dr. Bernadette E. Dzlvis-Lort 12. Any and all coliateral source/hsalth insurance providers E3, Employment records if iost earnings are being Glaixned 14. RS/W2 forms if lost ear11f11gs 81.e being claimed PLEASE TAKE NOTCE, that these authorizations are to contain the full name and addresses of the health care taciiities/p1*ovide1.s and any identification numbers neoessafy for the production.of records HPAA form. PLEASE TAKE FURTHER NOTCE, that said authorizatigms are to be provided on the proper PLEASE TAKE FURTHER NOTCE, that said authorizations are to permit the release of all radiological studies, including MRs and CT Scans. PLEASE TAKE FURTHER NOTCE, that failure to comply with this demand will lead 'to a motion for the appropriate reiief. Dated: Rye Brook, New York October 12, 2016 By: MARS HALL DENNEHEY W ARNER COLEMAN & GOGGN f' / " " Charies T. Gura, Esq. Attomeys for Defendants SAMER JABER, MJ) 800 Westchester Avenue, Suite C-700 Rye Brook, New Yoirk 10573 (914)-977-7300 File No.: 40467.00150 2 LEGAL/30'/'257097.v 1
TO : Da nie l H. We ine r, Pro S e 45 Bre voort Roa d Chappaqua, New York 1 D514 Home: (914) 238~4318 Ce ll: (917) 574-3407 Ema il: daniel.weine1.@hugheshubba rd.com He ide ll, Pittoni, Murphy & Ba ch Attorne ys for De fe nda nt Rigs ] De rma tology, PLLC 99 Park Avenue, -7 h Floor Ne w York, NY 10016 (212) 286-8585 S tua rt Be rns te in, Es q. Kos te r, Bra dy & Na g le r, LLP Attorne ys for De fe nda nt S c hwe ig e r De xma tology Group, LLC One W hite ha ll S tre e t, 1081 Floor Ne w York, Ne w Yo rk 1 0 0 0 4 (2 1 2) 2 4 8-8800 3 LEGAL/l072S7097,v
-AFFD*AtV1T OF serv1g;: S TATE OF NEW YOR K COUNTY OF W18lS'l`CHESTER ) ): ss, ) ADAMANDA POLYGERNOS, being duiy sworn, deposes and says: York. Deponcnt is H01 a party to the action is over 18 ye a rs of a g e a nd re s ide s in W e s tche s te r, Ne w On October V, 2036, served the annexeddemand FOR AUTHORZATONS on: :Daniel H. Weiner, Pro Se 45 Brevoort Road Chappaqua, New York 10514 Home: (914) 238-4318 Cell: (917) 574-3407 Email: daniel,weiner@hugheshubba:rd.com Heidell, Pittoni,.Murphy 84.Bach Attorneys for Defendant Rigel Darmatology, PLLC 99 Park Avenue, 7131 Floor New York, NY 10816 (212)286-8585 Stuart Bernstein, Esq. Koster, Brady & Nagler, LLP Attorneys for Defendant Sohweiger Dermatology Group, LLC One Whitehall Street, lou! Floor New York, New York 10004 (232) 248-8800 at the addresses designated by said attorneys for that purpose, by depositing true copies ofsame enclosed in a postpaid, properly addressed wrappers in an official depository under the exclusive care and custody of 'the United States.Postal Services within the State ofnew York, S wom to be fore me this 1 da y of Octobe r, 2016....= 2' -J -'Q-»&./\_ w- 80Lx»*.f')[" Notary Public J \ m4&0l,, L- >l Q ADAMANDA POLY.4 NGS ELEEN LAVELU8 Notary Public, Stale of New York No.0 LA6197308 Qualificd in Westchester Cnunty Commission Expires# November 24, 20 6 4 LFGAL./1072S7097.v
lnm2xno.' 805350/2016 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF NEW YORK DANEL -. WENER, against - Plaintiff, SAMER JABER, M,D., RGEL DERMATOLOGY, PLLC and SCHW EGER DERMATOLOGY GROUP, LLC, Defendants. DEMAND FOR AUTHORZATONS MARSHALL DENNEHEV WAnLn18n.Co1.18 v1an & GOGQ1N A Trofzlwzns FOR DEFENDANT SAMER JABER, MD. 800 WEs'rcHr~:sT 2R AvBt~tuE, Su1T8 C-700 RYE: BROOK, Nnsw YORK 10573 (914)977-7300 PURSUANT To 22 NYCRR 130-1.1, THE UNDERSGNED, AN ATTORNEY ADMTTBD To p:<actcrs N THE COURTS on N 8wYORKSTATE, CERTFES'l' A'`, UPONNFORMATONANDBBLEFANDREASONABLLNQURY, J THECONFENTONS CONTANEDNTHEANNEXEDDOCUMENT ARE NOT FRVOLOUS. DA'rBo: October \ ' \, 2 016 SGNATURE PRNT S1GNER'S NAME. Sl8Rvlcli OF A COl'Y OF*ms WTHN DATES S HEREBY ADMTTED. ATTORNEV(S) FOR