IndividualActive
Jan Idzikowski, PA
NPI 1629074505 · Surgical Physician Assistant · New London, NH
Provider details
- NPI number
- 1629074505
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- 585 (CO)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
273 County Rd
New London, NH 03257-5736
Phone: (603) 526-2911
Approximate (ZIP-level) locationGet directions
Mailing address
273 County Rd
New London, NH 03257-5736
Registry dates
- Enumerated
- 2005-06-24
- Last updated
- 2020-01-08
- Certified
- 2020-01-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.