Healthcare Provider Details

I. General information

NPI: 1164162152
Provider Name (Legal Business Name): SARAH NICOLE JEMIOLO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH PETERSON MD

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 BELLEVUE AVE
CINCINNATI OH
45219-3158
US

IV. Provider business mailing address

3200 BURNET AVE
CINCINNATI OH
45229-3019
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8730
  • Fax: 513-475-8033
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35.156288
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: