Provider Demographics
NPI:1093096430
Name:ZYMBLOSKY, JEFFREY P (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:P
Last Name:ZYMBLOSKY
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1605
Mailing Address - Country:US
Mailing Address - Phone:570-342-8936
Mailing Address - Fax:570-343-1455
Practice Address - Street 1:539 LINDEN ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1605
Practice Address - Country:US
Practice Address - Phone:570-342-8936
Practice Address - Fax:570-343-1455
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444669183500000X
PARPI002256183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist