# MOUNT NITTANY MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MOUNT NITTANY MEDICAL CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1669301883
- **Legal business name:** MOUNT NITTANY MEDICAL CENTER
- **Authorized official:** BRYAN ROACH (CFO)
- **Authorized official phone:** (814) 234-6148

## Contact information

- **Practice address:** 2121 OLD GATESBURG RD STE 100, STATE COLLEGE, PA 16803-2290
- **Practice address phone:** (814) 231-7277
- **Practice address fax:** (814) 231-7098
- **Mailing address:** 155 WELLNESS WAY, STATE COLLEGE, PA 16803-6702
- **Mailing address phone:** (814) 231-7100
- **Mailing address fax:** (814) 238-0790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS1201X | Sleep Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS1201X | Sleep Medicine (Family Medicine) Physician | — | — | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | — |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/14/2026
- **Last updated:** 05/14/2026