JAN IDZIKOWSKI


Address: 273 County Rd, New London, NH 03257-5736
Phone: 6035262911

JAN IDZIKOWSKI (NPI# 1629074505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629074505
Entity Type Individual
Full Name JAN IDZIKOWSKI
Credential PA
Practice Address 273 County Rd
New London
NH 03257-5736
Practice Telephone 6035262911
Enumeration Date 2005-06-24
Last Update Date 2020-01-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
1188 NH Physician Assistants & Advanced Practice Nursing Providers
N 363AS0400X Physician Assistant
Specialization: Surgical Technologist
585 CO Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CO 42889057 05

Office Location

Street Address 273 COUNTY RD
City NEW LONDON
State NH
Zip Code 03257-5736

Providers in the same location

NPI Name Taxonomy Address Enumeration
1174124705 Samantha Marie Rossignol Student in an Organized Health Care Education/Training Program 273 County Rd, New London, NH 03257-5736 2020-11-02
1437780376 Jennifer Norris Student in an Organized Health Care Education/Training Program 273 County Rd, New London, NH 03257-5736 2020-01-29
1578046496 Madelynn Vassallo Social Worker 273 County Rd, New London, NH 03257-5736 2018-09-07
1639610611 The New London Hospital Association, Inc. Ambulance 273 County Rd, New London, NH 03257-5736 2017-03-10
1851842678 Elke Melody Dietitian, Registered 273 County Rd, New London, NH 03257-5736 2016-10-17
1801342936 Birgit Humpert Dietitian, Registered 273 County Rd, New London, NH 03257-5736 2016-08-29
1184019804 New London Hospital Inc General Acute Care Hospital 273 County Rd, New London, NH 03257-5736 2015-03-31
1124432216 John Malcolm Family Medicine 273 County Rd, New London, NH 03257 2014-06-17
1053721340 Rebecca Wood Internal Medicine 273 County Rd, New London, NH 03257-5736 2014-05-07
1750701595 John Lagasse Registered Nurse 273 County Rd, New London, NH 03257-5736 2014-04-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295357218 Glenn L Perreault Pharmacist 82 Newport Rd, New London, NH 03257 2020-05-13
1740733047 Patricia Martick-campbell Counselor 32 Goosehole Lane, New London, NH 03257 2016-08-03
1033535836 Concord Pediatric Dentistry of New London, Pllc Point of Service 299 Main St., New London, NH 03257 2014-03-17
1285926071 Nicholas Chester Reynolds Jr. Surgery 153 Seamans Road, New London, NH 03257 2011-05-11
1366693426 Marlene G Meinelt Social Worker 35 Newport Road, New London, NH 03257 2008-10-08
1053562140 Olivia Powers Weathers Chiropractor 71 Pleasant Street, New London, NH 03257 2008-10-07
1851569768 Gregory P. Gutgsell Dds & Darren M Phipps Dds, Prof Assn Dentist 125 Newport Road, New London, NH 03257 2008-02-13
1093992000 Christine Ann Dube Family Medicine 273 Country Road, New London, NH 03257 2008-01-22
1477743615 Elizabeth Ann Johnston Social Worker The Gallery, 276 Newport Rd., Suite 202, New London, NH 03257 2007-07-25
1922215946 Anthony Joseph Yuskaitis Family Medicine 868 Morgan Hill Rd., New London, NH 03257 2007-05-17
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1558319194 Arthur S Welch Physician Assistant 50 Fair Harbour Pl, Suite 2-a, New London, CT 06320-4731 2006-05-05
1508429275 Marissa Ann Sylvester Physician Assistant 365 Montauk Ave, New London, CT 06320-4700 2019-04-18
1295213320 Kelsey Bestall Physician Assistant 365 Montauk Ave, New London, CT 06320-4700 2018-07-31
1669889481 Heather Nickerson Physician Assistant 365 Montauk Ave, New London, CT 06320-4700 2014-07-14
1669809927 L&m Medical Group Physician Assistant 365 Montauk Ave, New London, CT 06320-4700 2013-10-02
1699910489 Taryn Fabian Physician Assistant 365 Montauk Ave, New London, CT 06320-4700 2008-12-08
1669684205 Margo R. Coffey Physician Assistant 365 Montauk Ave, New London, CT 06320-4700 2007-05-04
1326182650 Juan C Delprado Physician Assistant 365 Montauk Ave, New London, CT 06320-4700 2007-02-19
1275696304 Marcelle Loranger Cashman Physician Assistant 365 Montauk Ave, New London, CT 06320-4700 2006-12-19
1134132244 Jenine Decaprio Gesino Physician Assistant 365 Montauk Ave, New London, CT 06320-4700 2006-08-14
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Competitor

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City NEW LONDON
Zip Code 03257

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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