Provider Demographics
NPI:1649218751
Name:COCO, ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:COCO
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 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:554 N DUKE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2225
Practice Address - Country:US
Practice Address - Phone:717-544-1960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055338L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000800462OtherHIGHMARK
PA001534575 0002Medicaid
PA20007895OtherAMERIHEALTH MERCY
PAP002755OtherGATEWAY
PA000000190848OtherUNISON - OB#
PAP00176926OtherRR MEDICARE
PA0824180000OtherIBC / AMERIHEALTH 65
PA261310OtherHEALTH AMERICA
PA50055826OtherCAPITAL BLUE CROSS
PA000000190823OtherUNISON - PCP#
PA5592363OtherCIGNA
PA3119OtherHEALTH PARTNERS
PA800462Medicare ID - Type Unspecified