Provider Demographics
NPI:1871233122
Name:TALANIAN, SANDRA A (BSN, MPH)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:A
Last Name:TALANIAN
Suffix:
Gender:F
Credentials:BSN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2098
Mailing Address - Street 2:
Mailing Address - City:EDGARTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02539-2098
Mailing Address - Country:US
Mailing Address - Phone:178-142-4456
Mailing Address - Fax:
Practice Address - Street 1:MARTHA'S VINEYARD HOSPITAL
Practice Address - Street 2:1 HOSPITAL ROAD
Practice Address - City:OAK BLUFFS
Practice Address - State:MA
Practice Address - Zip Code:02557
Practice Address - Country:US
Practice Address - Phone:508-693-0410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2339560163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory