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General NPI Number Information
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NPI Number | 1669301883
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Entity Type | Organization
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Legal Business Name | MOUNT NITTANY MEDICAL CENTER
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 2121 OLD GATESBURG RD STE 100
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City | STATE COLLEGE
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State | PA
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Zip | 16803-2290
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Country | US
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Telephone | 814-231-7277
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Fax | 814-231-7098
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Provider Business Mailing Address
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Address Line | 155 WELLNESS WAY
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City | STATE COLLEGE
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State | PA
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Zip | 16803-6702
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Country | US
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Telephone | 814-231-7100
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Fax | 814-238-0790
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Authorized Official
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Title or Position | CFO
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Name | BRYAN ROACH
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Credential |
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Telephone | 814-234-6148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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