| Doctor Name: | MRS. TAHIRA DOCKERY |
| NPI Number: | 1427342781 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP011319 |
| Business Practice Address: | 157 Bustleton Pike # 161 Feasterville Trevose, PA - 190536480 |
| Business Phone Number: | 2153220222 |
| Business Fax Number: | |
| Mailing Address: | 7102 N Broad St, PHILADELPHIA |
| State: | PA |
| Postal Code: | 191261726 |
| Phone Number: | 2678088810 |
| Fax Number: | |
| NPI Enumeration Date: | 06/04/2011 |
| NPI Last Update Date: | 06/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | SP011319 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |