Individual
JACK E LUBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
425 SALEM ST, MEDFORD, MA 02155-3337
(781) 933-3734
Mailing address
8 ISLAND WAY, ANDOVER, MA 01810-6043
(781) 933-3734
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PD1514
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0334189
—
MA
01
—
795450
TUFTS HEALTH CARE
MA
01
—
Y70615
BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/01/2006
Last updated
07/08/2007
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