MEDICARE: NICHOLAS J COIA III

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	25MP00741800	NJ

General Provider Information

NPI Number	:	1174298202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS J COIA III

Provider Business Mailing Address
First Line	:	833 CHESTNUT ST STE 520
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4430
Country	:	US
Telephone Number	:	800-321-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 ENGLISH CREEK AVE
Second Line	:	BLDG 1300
City	:	EGG HARBOR TWP
State	:	NJ
Zip	:	08234-5549
Country	:	US
Telephone Number	:	800-321-9999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2021
Last Update Date	:	01/13/2026

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