Provider Demographics
NPI:1932966223
Name:SEIDLER, ABIGAIL (PA-C)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:SEIDLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19036 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-2239
Mailing Address - Country:US
Mailing Address - Phone:636-346-4705
Mailing Address - Fax:
Practice Address - Street 1:9494 W NORTHERN AVE STE 101
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-1119
Practice Address - Country:US
Practice Address - Phone:623-872-2226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant