Provider Demographics
NPI:1528253788
Name:CHUDZINSKI, ABIGAIL CHRISTINE (DO)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:CHRISTINE
Last Name:CHUDZINSKI
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 1:282 BENEDICT AVE
Mailing Address - Street 2:STE B
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2712
Mailing Address - Country:US
Mailing Address - Phone:419-668-9409
Mailing Address - Fax:419-668-7099
Practice Address - Street 1:282 BENEDICT AVE
Practice Address - Street 2:STE B
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2712
Practice Address - Country:US
Practice Address - Phone:419-668-9409
Practice Address - Fax:419-668-7099
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.010030208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0065328Medicaid