Provider Demographics
NPI:1770654477
Name:LUKA, KIRA ANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:ANNE
Last Name:LUKA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KIRA
Other - Middle Name:ANNE
Other - Last Name:TARASI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:201 MARY ANN DR
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-2509
Mailing Address - Country:US
Mailing Address - Phone:412-512-4168
Mailing Address - Fax:
Practice Address - Street 1:4401 PENN AVE
Practice Address - Street 2:STE 142
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1334
Practice Address - Country:US
Practice Address - Phone:412-578-1413
Practice Address - Fax:412-692-6180
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051147363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical