Individual
MATTHEW RICHARD EERNISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1700 OLD GATESBURG RD STE 300, STATE COLLEGE, PA 16803-2276
(814) 234-1002
(814) 234-6251
Mailing address
1700 OLD GATESBURG RD STE 300, STATE COLLEGE, PA 16803-2276
(814) 234-1002
(014) 234-6251
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG003709
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG003709
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103797012
—
PA
Enumeration date
04/13/2020
Last updated
06/16/2025
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