Provider Demographics
NPI:1356233480
Name:ZYBERT, JASON EDWARD (PHARMD, MS)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:EDWARD
Last Name:ZYBERT
Suffix:
Gender:X
Credentials:PHARMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 JUNIPER DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3414
Mailing Address - Country:US
Mailing Address - Phone:401-222-9542
Mailing Address - Fax:
Practice Address - Street 1:536 SAYBROOK RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4783
Practice Address - Country:US
Practice Address - Phone:860-358-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00111091835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist