Healthcare Provider Details

I. General information

NPI: 1982050118
Provider Name (Legal Business Name): SARAH SITTENFELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH COYNE

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 06/09/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

2830 VICTORY PARKWAY PAYOR ENROLLMENT
CINCINNATI OH
45206-1785
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-3494
  • Fax: 513-584-4007
Mailing address:
  • Phone: 513-585-5507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35.141647
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: