MEDICARE: DR. JARRED CORY ZUCKER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	042.0013909	VT
2	390200000X	Student in an Organized Health Care Education/Training Program	272808	NY

General Provider Information

NPI Number	:	1215249560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARRED CORY ZUCKER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 101
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05302-0101
Country	:	US
Telephone Number	:	802-258-3700
Fax Number	:	802-258-3723

Provider Business Practice Location Address
First Line	:	22 ANNA MARSH LANE
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301
Country	:	US
Telephone Number	:	802-258-3700
Fax Number	:	802-258-3723

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2010
Last Update Date	:	05/28/2026

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