MEDICARE: VETERAN'S ADMINISTRATION HOSPITAL

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	282N00000X	General Acute Care Hospital	11870	MA

General Provider Information

NPI Number	:	1013075811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VETERAN'S ADMINISTRATION HOSPITAL

Provider Business Mailing Address
First Line	:	211 BELLEVUE ST
Second Line	:
City	:	WEST ROXBURY
State	:	MA
Zip	:	02132-6407
Country	:	US
Telephone Number	:	617-469-3636
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 BELLEVUE ST
Second Line	:
City	:	WEST ROXBURY
State	:	MA
Zip	:	02132-6407
Country	:	US
Telephone Number	:	617-469-3636
Fax Number	:

Authorized Official
Title or Position	:	SOCIAL WORKER
Name	:	PATRICIA FALETRA
Credential	:	LICSW
Telephone Number	:	857-203-5527

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	08/22/2020

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