Healthcare Provider Details

I. General information

NPI: 1700719580
Provider Name (Legal Business Name): JONI KADRIOSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 STANLEY ST
NEW BRITAIN CT
06050-2439
US

IV. Provider business mailing address

15 RODNEY TER
PROSPECT CT
06712-1322
US

V. Phone/Fax

Practice location:
  • Phone: 860-832-3200
  • Fax:
Mailing address:
  • Phone: 203-435-0525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: