Provider Demographics
NPI:1093791683
Name:COIA, LAWRENCE R (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:R
Last Name:COIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020A E BOAL AVE
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-1509
Mailing Address - Country:US
Mailing Address - Phone:814-237-8627
Mailing Address - Fax:814-238-0083
Practice Address - Street 1:1140 ROUTE 72 W
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2412
Practice Address - Country:US
Practice Address - Phone:609-978-2194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA036222002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ860651OtherAMERIHEALTH PPO
NJ0967851000OtherAMERIHEALTH HMO/POS
NJ223444048OtherHORIZON BCBS
NJ5425296OtherAETNA PPO
NJP2063642OtherOXFORD
NJ1957104Medicaid
NJ223690354OtherHORIZON BCBS
NJ28535OtherUNIVERSITY HEALTH PLAN
NJ1K4988OtherHEALTHNET
NJ2351599OtherAETNA HMO
NJ60013696OtherHORIZON NJ HEALTH
NJ920005650Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NJ860651PB6Medicare ID - Type Unspecified
NJ1K4988OtherHEALTHNET
NJ860651DM2Medicare ID - Type Unspecified