Healthcare Provider Details

I. General information

NPI: 1164347795
Provider Name (Legal Business Name): VETERANS AFFAIRS MEDICAL CENTER WEST ROXBURY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MILL ST
BELMONT MA
02478-1064
US

IV. Provider business mailing address

115 BEAVER ST
BOSTON MA
02136-1714
US

V. Phone/Fax

Practice location:
  • Phone: 800-333-0338
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. NAOMI NKECHINYERE OKAFOR SR.
Title or Position: MEDICAL LAB SCIENTIST ASCP/MLT
Credential: MD
Phone: 857-230-2729