Provider Demographics
NPI:1780165498
Name:ZOMBIL, STEPHEN (DNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:ZOMBIL
Suffix:
Gender:M
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 BELMONT ST RM 43
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2964
Mailing Address - Country:US
Mailing Address - Phone:508-796-0730
Mailing Address - Fax:508-519-0488
Practice Address - Street 1:116 BELMONT ST RM 43
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2964
Practice Address - Country:US
Practice Address - Phone:508-796-0730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2284540363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health