Provider Demographics
NPI:1306114095
Name:DR DARRYL R VOIGHT,OD, PC
Entity type:Organization
Organization Name:DR DARRYL R VOIGHT,OD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:R
Authorized Official - Last Name:VOIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-616-9999
Mailing Address - Street 1:1680 STATE ROUTE 23 STE 170
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-7511
Mailing Address - Country:US
Mailing Address - Phone:973-616-9999
Mailing Address - Fax:973-616-2737
Practice Address - Street 1:1680 STATE ROUTE 23 STE 170
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-7511
Practice Address - Country:US
Practice Address - Phone:973-696-2020
Practice Address - Fax:973-696-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA000537100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU59160Medicare UPIN
NJ233098Medicare PIN
NJ1224660001Medicare NSC
NJU59160Medicare UPIN