Healthcare Provider Details

I. General information

NPI: 1356233480
Provider Name (Legal Business Name): JASON EDWARD ZYBERT PHARMD, MS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 SAYBROOK RD
MIDDLETOWN CT
06457-4783
US

IV. Provider business mailing address

45 JUNIPER DR
AVON CT
06001-3414
US

V. Phone/Fax

Practice location:
  • Phone: 860-358-2040
  • Fax:
Mailing address:
  • Phone: 401-222-9542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0011109
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: