Healthcare Provider Details

I. General information

NPI: 1699404103
Provider Name (Legal Business Name): SARAH ANN BASQUEZ AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 CAMPUS DR STE C
SCARBOROUGH ME
04074-7229
US

IV. Provider business mailing address

92 CAMPUS DR STE C
SCARBOROUGH ME
04074-7229
US

V. Phone/Fax

Practice location:
  • Phone: 207-797-5753
  • Fax: 207-797-9571
Mailing address:
  • Phone: 207-797-5753
  • Fax: 207-797-9571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAP3710
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: