Individual provider · Type 1 NPI
Jan Idzikowski, PA
Surgical Physician Assistant · New London, NH
NPI number
1629074505
Active
Practice location
273 County Rd
New London, NH 03257-5736
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 585 (CO) |
| Surgical Physician Assistant Primary | 363AS0400X | 1188 (NH) |
Surgical Physician Assistant: Definition to come...
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About NPI 1629074505
Jan Idzikowski, PA's National Provider Identifier is 1629074505, issued on Jun 24, 2005. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in New London, NH. The record was last updated on Jan 8, 2020.