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The Exigence Team

Exigence has assembled a deep pool of talent including active physicians, experienced hospital administrators, functional experts, managers and entrepreneurs who listen, delve into data, imagine possibilities and partner to develop creative, custom healthcare solutions.

Leadership Team

Management Team

Leadership Team

Gregory F. Daniel, MD, MBA
Chief Executive Officer

Dr. Gregory Daniel brings a unique mix of skill, experience, and knowledge to the role of Exigence CEO. In addition to more than 20 years of experience as an emergency medicine physician, Dr. Daniel also has a keen business sense fostered with both real-life experience and an MBA degree. It is the combination of those skills that built the successful model that is Exigence.

Since he founded the organization in 2000, Dr. Daniel has used this model to provide a vision for the growth of the company. Dr. Daniel has personally directed a number of development efforts including successful contract negotiations with HMOs, establishment and implementation of operational policies and procedures, and the design and implementation of a partnership tract for Exigence professionals.

During the evolution of these efforts, continuous improvements to the company’s financial operations and physician and staff performance have blossomed. He has introduced numerous innovations and efficiencies, including identifying strategic expansion opportunities and the introduction of incentive structures with specific criteria for attainment and measurement.

With Dr. Daniel’s guidance, Exigence has expanded its footprint, further enhanced its reputation, and is known for strong management and fiscal responsibility. With attention to detail and an eye on the future, he has stressed the importance of innovation within the company to meet emerging client needs. The Buffalo Niagara Partnership honored Exigence and Dr. Daniel with their New Minority Business of the Year Award in 2006.

Dr. Daniel earned his doctorate of medicine and a bachelor’s degree in biochemistry from the University of Wisconsin, Madison, and is licensed to practice medicine in eight states. He earned his MBA from the University of California, Irvine, and was named “Best Leader” for his class. Dr. Daniel received the 2005 Business Leadership Buffalo Niagara award.

He is a member of the board of governors for the Catholic Independent Practice Association (IPA) of Western New York, where he serves on the negotiation and compensation and utilization committees. He’s held roles in the past with the U.S. Air Force Reserves and the U.S. Amateur Boxing Federation.

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Mark Celmer, MHA, FACHE
President, Exigence North America, LLC

Mark Celmer was named president of Exigence North America, LLC in January 2008.

Mr. Celmer brings nearly 35 years of experience in the medical and manufacturing industries to Exigence North America, LLC. As president he has responsibilities for day-to-day operations management of all of the company’s operating subsidiaries. Additionally, he is leading the business development division and growth initiatives over all current and future operating business lines throughout the U.S. and Canada.

Prior to joining Exigence, Mr. Celmer was president and CEO of Multisorb Technologies International, a leader in the design, development, production and marketing of products servicing numerous industries, including diagnostics, pharmaceuticals, electronics, and other specialty packaging.

Mr. Celmer was president of Healthcare-Innovations, LLC, a Buffalo-based specialty consulting and Internet technology development firm which focused on the medical industry.

He spent five years as president and CEO of the WCA Healthcare System in Jamestown, NY. There he led nearly 1,500 employees, providing oversight on all activities. During his tenure he directed a turnaround of WCA Healthcare, which resulted in improved cash flow, debt position, cost structure and organizational effectiveness.

For eleven years Mr. Celmer was president and CEO of DeGraff Memorial Hospital, a 305-bed medical center in North Tonawanda, NY. There he directed a 1,100-employee organization. He played a key role in the transition of DeGraff with Buffalo General Hospital as the seed institution for what is now known as the Kaleida Health System. Mr. Celmer began his career at DeGraff as an associate administrator and also spent time as an associate administrator at the Washington Hospital Center in Washington, DC.

Mr. Celmer earned a master’s in hospital administration from The George Washington University and a bachelor’s degree in hospital administration from Ithaca College. He serves on the board of the Buffalo State Colleges Foundation, Roswell Park Cancer Institute, World Trade Center Buffalo/Niagara, INSYTE Consulting, and the Young Presidents and World Presidents Organizations.

He received Business First of Buffalo’s “40 Under 40 Leadership Award” and was named Young Hospital Administrator of the Year by the American College of Healthcare Administrators.

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Frank Lee, MD, FAAEM
Vice President of Medical Affairs

Making the connection between administration and the clinical aspects of our organization is where Dr. Frank Lee, our vice president of medical affairs, excels. Providing oversight of all clinical aspects within Exigence makes him a key figure in helping shape our future direction.

Dr. Lee quickly made a name for himself both within and outside of our organization. He was named a full general partner in 2002; three years later, as an Exigence regional director, he provided clinical and administrative expertise for our western region connections. He was named vice president in 2006.

He excels at identifying process improvement opportunities, analysis of processes, and has thorough knowledge in the implementation of electronic medical records systems.

Board certified in emergency medicine, Dr. Lee was named chair of the emergency department at St. Joseph Hospital in 2002, a position he maintains today. He spearheaded an initiative at St. Joseph’s called Project Renaissance, which has been met with high praise in the medical community. It featured the implementation of a new electronic medical records system, the first for a private ER in the region. He also led the design of the hospital’s new emergency department, which won several design element awards. The success of that effort has been measured in improvements in the patient length of stay, patient satisfaction, and increased volume.

St. Joseph Hospital recently honored Dr. Lee with the Caritas Award that recognizes outstanding service and dedication along with support to the community. He also serves on the hospital foundation’s board of directors.

Dr. Lee is a frequent lecturer to medical staffs and organizations on a range of topics related to emergency medicine. He is also certified in ultrasound. Dr. Lee continues to practice emergency medicine at St. Joseph Hospital, Mercy Hospital, Sisters of Charity Hospital, and urgent care facilities. He is also an assistant clinical professor.

He completed his residency at the University at Buffalo’s School of Medicine, earning his medical doctorate along with a bachelor’s degree in biological sciences from the University at Buffalo.

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Irving Levy, CPA
Chief Financial Officer

Bringing more than 20 years of experience to Exigence along with a thorough knowledge of healthcare practice management, Irv Levy serves as Chief Financial Officer, a role he has held since 2005.

His focus on growing the business through successful financial operations returns strong results for our organization and our clients. Mr. Levy is responsible for all accounting and reporting practices, billing and collections, human resources and recruitment of new physicians.

Mr. Levy’s keen ability to adapt to the ever-changing business environment and his expertise related to issues in healthcare practice management and administration gives Exigence a CFO who knows what it takes to continuously improve our operations and expand our business. In fact, his reputation in the industry has made him a popular consultant and sought-after speaker on physician practice management issues. He regularly conducts seminars locally and nationwide for the Medical Group Management Association.

His career path and experience has provided Mr. Levy with a strong background in physician practice management. He has been involved with projects involving medical practice profit enhancement, collections enhancements and the structure, sale and acquisition of medical practices.

He joined Exigence after spending 20 years at the regional accounting firm Freed Maxick & Battaglia. He was a managing director in the auditing and accounting department, chaired its physician practice niche, and built its business advisory services division from the ground up. That division accounted for 10 percent of the firm’s volume. Mr. Levy spent 13 years as a tax consultant where he managed federal, state and international tax issues for the firm.

During that time he was also a consultant for Exigence where he assisted with building our unique and successful membership model. Both a certified public accountant and a certified financial planner, he began his career at a small accounting firm in Houston, Texas.

Mr. Levy is a graduate of Canisius College. He is a member of the Healthcare Financial Management Association, the American Institute of Certified Public Accountants and the New York State Society of Certified Public Accountants.

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Nancy Ebling, DO
Vice President of Medical Affairs, Hospitalist Division

As the vice president of medical affairs for our hospitalist division, Dr. Nancy Ebling is leading the way for our managed care services in hospitals.

Dr. Ebling manages our contractual obligations to the hospitals we serve, ensuring that we provide the best possible service for our inpatient care operations. She manages the day-to-day operations of all physician-level services. Providing the highest level of service is job number one for Exigence, to ensure our pattern of growth continues, our name recognition increases and our customers are satisfied.

She joined Buffalo Emergency Associates in 2001 after completing her residency, and has been a key figure in the growth and development of our business ever since. She was promoted to vice president of the Exigence Hospitalist division in February 2007.

With her ambition to maintain first-hand knowledge of the needs of physicians and hospitals, Dr. Ebling also continues to practice medicine. She provides both hospitalist and emergency medicine services.

Dr. Ebling earned a Doctor of Osteopathy from the Lake Erie College of Osteopathic Medicine. She also holds a bachelor’s degree from Canisius College. She completed both her internship and her residency in internal medicine at Sisters of Charity Hospital in Buffalo.

Dr. Ebling is a member of the Society of Hospitalist Medicine, the American College of Internal Medicine and the American Osteopathic Association.

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Joseph DiVincenzo, JD
Corporate Counsel

Joseph DiVincenzo is one of the newest members of the leadership team at Exigence. He joined us in 2007 and plays a key role in expanding the business and helping to manage our daily operations.

As corporate counsel, he is primarily responsible for the negotiation and drafting of contracts for Exigence across a number of spectrums. He manages this process for personnel within our organization, doctors who join our team, hospitals with whom we work and insurance companies. It is a pivotal position requiring a broad base of knowledge and skill.

Mr. DiVincenzo’s role also encompasses our corporate governance, providing oversight to our entities and others with whom we are contracted. Additionally, he possesses a background in accounting which allows him to examine business contracts and operations from both a legal and fiscal standpoint.

Mr. DiVincenzo specializes in contract law, healthcare, litigation and intellectual property. He has argued cases successfully in New York State and throughout the country. He was successful in an intellectual property trademark case, the results of which have been published multiple times in various journals. In addition to being admitted to practicing law in New York State, Mr. DiVincenzo is also admitted to practice in various federal courts across the U.S.

Prior to taking on this role at Exigence, he worked as counsel for Bausch & Lomb in Rochester, NY. He serviced their global manufacturing and purchasing sector, which deals with operations in both the United States and in Europe. He provided oversight on the drafting and review of contracts, negotiations with prospective business partners and corporate governance.

Mr. DiVincenzo has also worked for the Buffalo firm of Hodgson Russ, where he practiced in their business litigation group and he worked as an accountant with Price Waterhouse. In addition, he previously was a member of the Erie County Board of Ethics.

He earned his law degree from the University at Buffalo. He formerly served as the assistant executive editor of The Buffalo Law Review. In addition, Mr. DiVincenzo received a Special Services Award from the Federal Western District of New York Bench and Bar and a writing award from the National Judges Association.

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Management Team

Joseph L. Chow, MD
Medical Director, Western New York Immediate Care

Clinical superiority and patient satisfaction are of utmost concern to Dr. Joseph L. Chow, Medical Director of Western New York Immediate Care (WNYIC). Dr. Chow leads by example—he consistently receives superior patient satisfaction scores with patients oftentimes citing his compassion and care as a primary reason for their positive experiences at our facilities.

Dr. Chow joined our organization in 2007. He organizes and oversees all medical care at the newest WNYIC facility in Orchard Park, NY, while he continues to share medical director responsibilities at a WNYIC facility in Amherst, NY.

Dr. Chow is board certified in family practice medicine. He is certified in advanced cardiac life support and pediatric advanced life support. He graduated Summa Cum Laude with a bachelor’s degree in biology from the University at Buffalo. He earned his medical doctorate from the University at Buffalo School of Medicine in 1997. Dr. Chow completed his residency in family medicine at the University at Rochester via Strong Memorial Hospital and Highland Hospital.

In addition to his position with WNYIC, Dr. Chow serves as Medical Director and Medical Review Officer for DuPont Industries in Buffalo, NY. He is Clinical Assistant Professor in the University at Buffalo’s Department of Family Medicine.

Dr. Chow serves on Young Physicians Committee of the Erie County Medical Society. He is also a member of the Western New York Physician Advisory Group of Univera Healthcare.

Prior to joining WNYIC, Dr. Chow was a Partner and Treasurer of Springville Pediatrics and Adult Care, LLP. He served as physician for the Gow School, the Springville Griffith Institute and for several group homes.

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Edward J. Cosgrove, MD, JD
Medical Director, Western New York Immediate Care

Dr. Edward J. Cosgrove is the medical director of Western New York Immediate Care’s Williamsville facility and co-director of a facility in Amherst, NY. Dr. Cosgrove is responsible for setting and maintaining policies for medical care, providing oversight and quality assurance for physicians and staff, assisting with physician recruiting and patient satisfaction.

An original partner in Exigence, Dr. Cosgrove has played a key role in the development of the company. He is board certified in internal medicine with over 10 years’ experience working in emergency departments. He is certified in advanced cardiac life support, pediatric advanced life support and advanced trauma life support. A member of the Erie County and the New York State Medical Society along with the American Medical Association, he has also served on committees for the Erie County Medical Society.

He serves as an attending physician in the emergency departments of Sisters of Charity Hospital, St. Joseph Hospital, Kenmore Mercy Hospital, Mercy Hospital of Buffalo, and Olean General Hospital. He has also been a staff physician at Sheehan Memorial Hospital and the Erie County Holding Center and spent time as the team physician for the Canisius High School football team.

In addition to being a physician, Dr Cosgrove is an attorney. He graduated cum laude from the University at Buffalo School of Law in 2000. Admitted to the New York State Bar in 2000, Dr Cosgrove utilizes his law degree in the management of our urgent care operations and as an associate in practice with his family’s multispecialty law firm providing expertise on medical-legal issues.

Dr. Cosgrove graduated from the University at Buffalo School of Medicine and Biomedical Sciences in 1994, completing his residency in internal medicine at the University at Buffalo Health Consortium in 1997. He holds a bachelor’s degree in English from the University of Notre Dame.

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Donnie Farley, RN
Practice Manager, WNY Immediate Care and Pulse Occupational Medicine

Donnie Farley is the practice manager for WNY Immediate Care and Pulse Occupational Medicine. He provides administrative and operations oversight for the two locations. His responsibilities include planning and development, focusing on financial growth, quality assurance, and adherence to the company model. He also places an emphasis on responding to the needs of our medical staff, including physicians, physician assistants and nurses.

In addition, Mr. Farley oversaw the construction of the second location of WNY Immediate Care and Pulse, which is located on Niagara Falls Boulevard in Amherst. He is currently providing similar oversight of the construction of the third Immediate Care location in Orchard Park, scheduled for completion in July 2008.

He joined our organization in July 2007. He saw an opportunity to join a company that he saw as diverse and dynamic, and a company where he felt he could succeed and help to expand the business.

Along with his managerial skills, Mr. Farley has 15 years experience as a nurse and also works as a registered nurse for our organization.

Mr. Farley came to our organization from Kaleida Health, where he was the nurse manager at DeGraff Memorial Hospital in North Tonawanda, NY. In that position he managed nursing operations in the emergency room, intensive care department, GI lab and other areas. He introduced a patient flow process which reduced patient stays by nearly one hour and reduced the time it took for a patient to see a physician by more than 60 percent.

He is certified as a green belt in the process improvement program known as Six Sigma. On the medical side, Mr. Farley is certified in advanced cardiac life support and crisis prevention intervention.

Mr. Farley is currently enrolled in master’s degree program at Empire State College where he is focusing on business and policy studies. He earned a bachelor’s degree in business administration, also from Empire State College, and holds an associate’s degree in nursing.

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Amy Goliszek
Program Coordinator, Hospitalist Division

Amy Goliszek is the program coordinator for the Exigence Hospitalist Program. She manages the day-to-day operations of the hospitalist program, including scheduling, and stands as the key Exigence contact for hospital administration. She also plays an active role in recruiting and hiring staff for the hospitalist entities including physicians, physician assistants, nurse practitioners and administrative staff.

She and Dr. Nancy Ebling helped to launch the hospitalist program for Exigence in 2007. Currently Ms. Goliszek is responsible for managing Exigence hospitalist contracts for three medical centers in Western New York: the Erie County Medical Center in Buffalo, Mount St. Mary’s Hospital in Lewiston, and Olean General Hospital in Olean.

Ms. Goliszek came to Exigence in April 2007 after spending a few years as a practice manager at another local hospitalist group. In that role, she was also responsible for managing daily operations and recruitment.

She decided to join Exigence because of the opportunity to launch a new product at an organization that was already established, well respected and growing. She now has a focus on expanding our hospitalist program to other medical centers.

Ms. Goliszek is currently enrolled in the master’s of business administration program at Niagara University. She holds a bachelor’s degree in health and human service and a bachelor’s degree in psychology from the University at Buffalo.

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Claire S. Jones, MBA
Chief Marketing Officer

Claire Jones joined Exigence in March 2008. Her primary responsibilities are in the areas of image and marketing, brand development, Web strategy, publicity and media relations, competitive intelligence, and internal communication.

Ms. Jones has over 20 years of progressive experience in communication and marketing including but not limited to advertising, brand development and management, market research, and search engine marketing, as well as public relations, media relations and crisis communication.

For the past eight years, Ms. Jones was the Associate Vice President for College Relations at Buffalo State College, an organization with 1,800 employees, 11,000 students, and a $150 million budget. She led a 15-member team that helped to increase applications to the college 22 percent, increased Web site traffic 400 percent, developed a state-of-the-art electronic internal communication program, produced more than 150 publications annually, and developed an emergency notification system and protocol for the college.

Prior to this, Ms. Jones held communication and marketing positions with The Hotchkiss School, Baylor School, University at Buffalo and Mercer University Press.

A member of the American Marketing Association, American Advertising Federation, Coalition for Urban and Metropolitan Universities and Council for Advancement and Support of Education, Ms. Jones has published papers and presented at national conferences on communication and marketing issues. In addition, she has received numerous national awards.

Ms. Jones earned a bachelor’s degree from Purdue University in Communication and a master’s of business administration degree from the University at Buffalo.

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Susan S. Luff, MS
Director of Recruitment

With more than 25 years of sales and marketing experience, including several years working in the medical field, Susan Luff has vast knowledge at her fingertips as the director of recruitment and business development at Exigence.

She leads our recruiting efforts aimed at encouraging more physicians to join our team and more hospitals to take advantage of our skills to improve their emergency and in-patient operations.

Luff joined Exigence in 2007, fulfilling her desire to be a part of a dynamic entrepreneurial environment. What most attracted her to Exigence was the tremendous growth we have seen and the potential for future increases in business.

Prior to joining the Exigence team, Luff spent seven years at Independent Health, a local HMO. She was brought into their organization to help develop a self-insured division. That position was critical to the work that she does for Exigence today. She learned the basics of healthcare business, the necessity of balancing the needs and expectations of all involved parties and how to work to reduce risk and costs while improving healthcare outcomes. She was also a co-founder of InfoMiners, a healthcare decision support solution. It focused on data warehousing and support and was ultimately acquired by McKesson HBOC.

Luff is a member of the National Association of Physician Recruiters. Throughout her career she has also worked in higher education, publishing, and financial services.

She earned a master’s degree from Slippery Rock University in Pennsylvania and a bachelor’s degree from the State University of New York at Potsdam.

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Sami Manirath, JD
Practice Manager

Utilizing skills in finance, operations, labor and employee relations, legal, and project management, Sami Manirath ensures that our objectives are met, our clients are served and our business grows.

Ms. Manirath came to us from Cliffstar Corp. in Dunkirk, NY., where she was corporate director. In that role she initiated cost savings of more than $1 million with adjustments to health care benefit plans; negotiated a multi-million dollar business expansion incentive package; and led efforts in evaluating, selecting and negotiating manufacturing sites for capital expansion. Her development of policies for procurements and negotiated contracts resulted in additional cost savings.

Prior to that, Ms. Manirath introduced change management, reorganization and process and productivity performance improvement programs for the City of Dunkirk as corporate counsel/human resources director. She developed cooperative relationships with bargaining unit representatives leading to the creation of common goals, objectives and performance standards. She also served as a legal practitioner and assistant district attorney with the Chautauqua County (N.Y.) District Attorney’s office.

She earned her law degree from the University at Buffalo along with a bachelor’s degree from the State University of New York at Fredonia.

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Irene Nye, MBA
Practice Manager

Irene Nye is a practice manager for the emergency services unit of Exigence. She serves as the key liaison between Exigence and hospital administration, emergency room physicians, and other medical personnel. Ms. Nye joined Exigence in September 2006.

Prior to joining Exigence, Ms. Nye spent six years with the Catholic Health System where she was most recently the purchasing manager. In addition to managing the day-to-day operations of the purchasing department, she was involved in direct contract and price negotiations for four acute care facilities. Previous to that role, she was responsible for the review and approval of all new products in use at the four acute care facilities as senior director for value analysis. She also led an effort negotiating physician preference items that resulted in savings of more than $1.75 million.

Ms. Nye also spent 14 years as an instructor at the OSHA Training Center at Niagara County Community College. She was an OSHA 501 instructor and was the lead instructor for the development of medical programs pertaining to asbestos, hazardous waste management, lead and blood borne pathogen.

She began her career at Bertrand Chaffee Hospital as director of respiratory and cardiology service. She has also spent time at DeGraff Memorial Hospital as the director of occupational health services, Wyoming County Community Hospital as the assistant administrator for outpatient services, and at Brittanic Occupational Health Services/Amherst Training Associates, where she was the director of administrative and clinical services and was a program designer, trainer and safety auditor.

Ms. Nye earned a master’s in business administration from the University at Buffalo along with a bachelor’s of science degree from Medaille College.

A registered respiratory therapist, Nye also holds an associate’s degree in respiratory care technology.

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John Radford, MD, FAAEM
Director of Medical Management, Emergency Medicine Division

As the director of medical management for the Exigence emergency medical services unit, Dr. John Radford uses his emergency medicine and management skills to ensure patients at the emergency departments we service receive the highest level of care.

Dr. Radford is responsible for the recruitment and retention of physicians to the emergency medicine line of business and the site director for emergency department operations at Our Lady of Lourdes Hospital in Binghamton, NY and Lock Haven Hospital in Lock Haven, PA.

In addition, Dr. Radford continues to practice as an emergency medicine physician at the hospitals in Binghamton and Lock Haven. He also works at Mercy Hospital. In addition, he is an instructor at the University at Buffalo School of Medicine.

After spending seven years helping to lead a local emergency group, Dr. Radford joined Exigence in March 2007 because of the opportunity to join a diverse and growing company that serves various areas in the medical care field.

Dr. Radford was the director of the emergency medicine department at Brooks Memorial Hospital in Dunkirk, NY from 2001 to 2006, and the director at Niagara Falls Memorial Medical Center, from 2006 to 2007. In addition to professional and administrative responsibilities, he was co-director of commercial and volunteer EMS services.

Prior to that, Dr. Radford was the chief resident at the University at Buffalo School of Medicine and Dental Consortium. He was a grand rounds lecturer, responsible for scheduling residents and managing resident issues and he provided oversight for student teaching.

Dr. Radford is board certified by the American Board of Emergency Medicine and he is a member of the American Academy of Emergency Medicine. He earned his medical doctorate from the University at Buffalo School of Medicine in 1997, where he also holds a bachelor’s degree.

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