MEDICARE: MRS. NORMA K. WEITMAN 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	PRO21963-1	NY

General Provider Information

NPI Number	:	1770680936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NORMA K. WEITMAN LCSW

Provider Business Mailing Address
First Line	:	108 CEDAR HEIGHTS DR
Second Line	:
City	:	JAMESVILLE
State	:	NY
Zip	:	13078-9425
Country	:	US
Telephone Number	:	315-446-0307
Fax Number	:	315-446-4379

Provider Business Practice Location Address
First Line	:	108 CEDAR HEIGHTS DR
Second Line	:
City	:	JAMESVILLE
State	:	NY
Zip	:	13078-9425
Country	:	US
Telephone Number	:	315-446-0307
Fax Number	:	315-446-4379

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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