MEDICARE: CYRIL F. WEISNER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW-3025	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000246447	OTHER	HI	HMSA BILLING NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134201080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYRIL F. WEISNER LCSW

Provider Business Mailing Address
First Line	:	75-184 HUALALAI RD
Second Line	:
City	:	KAILUA KONA
State	:	HI
Zip	:	96740-1719
Country	:	US
Telephone Number	:	808-334-4400
Fax Number	:

Provider Business Practice Location Address
First Line	:	75-184 HUALALAI RD
Second Line	:
City	:	KAILUA KONA
State	:	HI
Zip	:	96740-1719
Country	:	US
Telephone Number	:	808-334-4400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	10/10/2007

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