Healthcare Provider Details

I. General information

NPI: 1053448498
Provider Name (Legal Business Name): JOHN J KADZIELSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CONGRESS ST STE 304
QUINCY MA
02169-0907
US

IV. Provider business mailing address

300 CONGRESS ST STE 304
QUINCY MA
02169-0907
US

V. Phone/Fax

Practice location:
  • Phone: 617-773-2200
  • Fax: 617-773-2202
Mailing address:
  • Phone: 617-773-2200
  • Fax: 617-773-2202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number239683
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberL-228167
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: