Provider Demographics
NPI:1437627569
Name:VOYSTOCK, PETER JAMES
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:JAMES
Last Name:VOYSTOCK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VETERANS' MULTI-SERVICE CENTER, 2ND FLOOR
Mailing Address - Street 2:213-217 N 4TH ST
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106
Mailing Address - Country:US
Mailing Address - Phone:215-764-7823
Mailing Address - Fax:
Practice Address - Street 1:VETERANS' MULTI-SERVICE CENTER, 2ND FLOOR
Practice Address - Street 2:213-217 N 4TH ST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106
Practice Address - Country:US
Practice Address - Phone:215-764-7823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW133527104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker