Provider Demographics
NPI:1083874986
Name:HANNA-TALBOT, CATHY A (NNP)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:A
Last Name:HANNA-TALBOT
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SAINT MARKS LN
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-4125
Mailing Address - Country:US
Mailing Address - Phone:631-581-4441
Mailing Address - Fax:
Practice Address - Street 1:41 SAINT MARKS LN
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-4125
Practice Address - Country:US
Practice Address - Phone:631-581-4441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF350184364S00000X, 363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist