Provider Demographics
NPI:1831441872
Name:TANKER, SHIRA JULIE (PA-C)
Entity type:Individual
Prefix:
First Name:SHIRA
Middle Name:JULIE
Last Name:TANKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHIRA
Other - Middle Name:JULIE
Other - Last Name:FINKELSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 8500-8735
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-456-7000
Mailing Address - Fax:215-456-5926
Practice Address - Street 1:5501 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3018
Practice Address - Country:US
Practice Address - Phone:215-456-6679
Practice Address - Fax:215-456-5926
Is Sole Proprietor?:No
Enumeration Date:2012-10-14
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055772363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical