MEDICARE: CYNTHIA J. JEMIOLA, O.D., INC

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	332H00000X	Eyewear Supplier	3452-T830	OH

General Provider Information

NPI Number	:	1760784060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CYNTHIA J. JEMIOLA, O.D., INC

Provider Business Mailing Address
First Line	:	5194 WILSON MILLS RD
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-3006
Country	:	US
Telephone Number	:	440-461-2500
Fax Number	:	440-461-2588

Provider Business Practice Location Address
First Line	:	5194 WILSON MILLS RD
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-3006
Country	:	US
Telephone Number	:	440-461-2500
Fax Number	:	440-461-2588

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. JANICE PILAR
Credential	:
Telephone Number	:	440-461-2500

Provider Enumeration Date	:	11/19/2010
Last Update Date	:	11/19/2010

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