Provider Demographics
NPI:1629719869
Name:VOYACK, ANDREW (DO)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:VOYACK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 QUEEN ST UNIT 14B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-4317
Mailing Address - Country:US
Mailing Address - Phone:856-296-5355
Mailing Address - Fax:
Practice Address - Street 1:ONE MEDICAL CENTER BLVD.
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013-4490
Practice Address - Country:US
Practice Address - Phone:856-296-5355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-03
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAOT022435207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program