Provider Demographics
NPI:1720430218
Name:GORELL, EMILY SARAH (DO)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:SARAH
Last Name:GORELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3334 BROTHERTON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1302
Mailing Address - Country:US
Mailing Address - Phone:707-319-9269
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-3506
Practice Address - Fax:513-636-5867
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34.016445207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program