Provider Demographics
NPI:1831170349
Name:ZEBRUN, JOHN M (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:ZEBRUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:47 PLEASANT ST STE 1-NW
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3984
Mailing Address - Country:US
Mailing Address - Phone:413-570-0425
Mailing Address - Fax:413-650-5581
Practice Address - Street 1:241 KING ST
Practice Address - Street 2:SUITE 215
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2335
Practice Address - Country:US
Practice Address - Phone:413-570-0425
Practice Address - Fax:413-650-5581
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA792742084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1831170349OtherNPI
MA1831170349OtherNPI
MAF67260Medicare UPIN