Provider Demographics
NPI:1275426967
Name:LUBAN, JEREMY (MD)
Entity type:Individual
Prefix:PROF
First Name:JEREMY
Middle Name:
Last Name:LUBAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 PLANTATION ST # N2-1099
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2324
Mailing Address - Country:US
Mailing Address - Phone:508-856-6899
Mailing Address - Fax:
Practice Address - Street 1:366 PLANTATION ST # N2-1099
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2324
Practice Address - Country:US
Practice Address - Phone:508-856-6899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator