Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JAN IDZIKOWSKI, PA
ActiveJAN IDZIKOWSKI, PA is a Surgical Physician Assistant healthcare provider located in NEW LONDON, New Hampshire. NPI 1629074505 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · NEW LONDON, NH
Registration Details
- NPI Number
- 1629074505
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 24, 2005 (21.117438708935 yrs)
- Last Updated
- Jan 8, 2020
- Licenses
-
585 (CO)1188 (NH)
Practice Information
- Address
-
273 COUNTY RDNEW LONDON, NH, 032575736Browse NH providers · Browse ZIP 03257
- Phone
- 6035262911
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
- Additional Specialty
- Surgical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.