MEDICARE: JOAN NAKAMATTE SUBER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN10019676	MA

General Provider Information

NPI Number	:	1952102659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN NAKAMATTE SUBER

Provider Business Mailing Address
First Line	:	25 ELLIOT ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02461-1604
Country	:	US
Telephone Number	:	978-942-9894
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 ELLIOT ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02461-1604
Country	:	US
Telephone Number	:	978-942-9894
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2025
Last Update Date	:	03/20/2025

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