Provider Demographics
NPI:1942432034
Name:SEDENKA, ABIGAIL J (AUD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:J
Last Name:SEDENKA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:J
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:100 GANNETT DRIVE
Mailing Address - Street 2:SUITEC
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-5900
Mailing Address - Country:US
Mailing Address - Phone:207-828-0361
Mailing Address - Fax:207-874-1483
Practice Address - Street 1:100 FODEN RD, WEST
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2327
Practice Address - Country:US
Practice Address - Phone:207-347-2910
Practice Address - Fax:207-523-8591
Is Sole Proprietor?:No
Enumeration Date:2009-08-22
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP1933237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME002108404Medicare PIN
ME002108403Medicare PIN
ME002108401Medicare PIN