Healthcare Provider Details

I. General information

NPI: 1407808298
Provider Name (Legal Business Name): WILLIAM J MARTYAK PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4186 CORTLAND DR
NEW PARIS PA
15554-7706
US

IV. Provider business mailing address

4186 CORTLAND DR
NEW PARIS PA
15554-7706
US

V. Phone/Fax

Practice location:
  • Phone: 814-839-4108
  • Fax: 814-839-4845
Mailing address:
  • Phone: 814-839-4108
  • Fax: 814-839-4845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA003500L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: