Basic Information
| Provider Information | |||||||||
| NPI: | 1649218751 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COCO | ||||||||
| FirstName: | ANDREW | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 555 N DUKE ST | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176022250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175445511 | ||||||||
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| Practice Location | |||||||||
| Address1: | 554 N DUKE ST | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176022225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175441960 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 04/14/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD055338L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000800462 | 01 | PA | HIGHMARK | OTHER | 001534575 0002 | 05 | PA | MEDICAID | 20007895 | 01 | PA | AMERIHEALTH MERCY | OTHER | P002755 | 01 | PA | GATEWAY | OTHER | 000000190848 | 01 | PA | UNISON - OB# | OTHER | P00176926 | 01 | PA | RR MEDICARE | OTHER | 0824180000 | 01 | PA | IBC / AMERIHEALTH 65 | OTHER | 261310 | 01 | PA | HEALTH AMERICA | OTHER | 50055826 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 000000190823 | 01 | PA | UNISON - PCP# | OTHER | 5592363 | 01 | PA | CIGNA | OTHER | 3119 | 01 | PA | HEALTH PARTNERS | OTHER |