Healthcare Provider Details

I. General information

NPI: 1083807648
Provider Name (Legal Business Name): DEPARTMENT OF VETERAN AFFAIRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 08/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SPRINGS RD SOCIAL WORK SERVICES, B9
BEDFORD MA
01730-1114
US

IV. Provider business mailing address

200 SPRINGS RD SOCIAL WORK SERVICES, B9
BEDFORD MA
01730-1114
US

V. Phone/Fax

Practice location:
  • Phone: 781-687-2375
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number State

VIII. Authorized Official

Name: MRS. SUSAN MAGIERA
Title or Position: NPI COORDINATOR
Credential:
Phone: 781-687-2260