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Organization
MOUNT NITTANY MEDICAL CENTER
Active
Organization
MOUNT NITTANY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN ROACH (CFO)
(814) 234-6184
Entity
Organization
Contact information
Practice address
155 WELLNESS WAY, STATE COLLEGE, PA 16803-6797
(814) 231-7168
(814) 235-7381
Mailing address
PO BOX 411847, BOSTON, MA 02241-1834
(814) 234-6199
(814) 235-7843
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
06/19/2012
Last updated
07/07/2026
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