NPI 1104808369 · live from the CMS NPI Registry
Jason D. Andrus, PA-C
Physician Assistant, Surgical in Meriden, CT. National Provider Identifier 1104808369, active.
NPI record
| NPI | 1104808369 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Surgical 363AS0400X |
| Practice location | 435 Lewis Ave, Meriden, CT 06451 |
| Practice phone | 833-203-7523 |
| Enumerated | November 15, 2005 |
| Last updated | August 7, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Surgical primary | 363AS0400X | 1011 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.