Provider Demographics
NPI:1992793376
Name:VOIGHT, DARRYL R (OD)
Entity type:Individual
Prefix:
First Name:DARRYL
Middle Name:R
Last Name:VOIGHT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 BLACK OAK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-6406
Mailing Address - Country:US
Mailing Address - Phone:973-616-9999
Mailing Address - Fax:973-616-2737
Practice Address - Street 1:879 BLACK OAK RIDGE RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6406
Practice Address - Country:US
Practice Address - Phone:973-616-9999
Practice Address - Fax:973-616-2737
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA 005371152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ410034964OtherRAILROAD MEDICARE
NJ410034964OtherRAILROAD MEDICARE
NJU59160Medicare UPIN
NJ812350Medicare PIN