Healthcare Provider Details

I. General information

NPI: 1043190499
Provider Name (Legal Business Name): JOHN KADZIELSKI MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CONGRESS ST STE 304
QUINCY MA
02169-0907
US

IV. Provider business mailing address

PO BOX 3160
ANDOVER MA
01810-0803
US

V. Phone/Fax

Practice location:
  • Phone: 617-773-2200
  • Fax: 617-773-2202
Mailing address:
  • Phone: 978-474-8885
  • Fax: 978-474-8845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN J KADZIELSKI
Title or Position: MD, OWNER, AUTHORIZED OFFICIAL
Credential: MD
Phone: 617-549-5219