Organization
NITTANY ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY MICHAEL HULEK (OFFICE MANAGER)
(814) 861-2177
Entity
Organization
Contact information
Practice address
101 REGENT CT, STATE COLLEGE, PA 16801-7965
(814) 231-2102
Mailing address
PO BOX 223, STATE COLLEGE, PA 16804-0223
(814) 861-2177
(814) 238-2278
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018963220001
—
PA
01
—
03091200
CAPITAL BLUE CROSS
PA
01
—
1338851
KEYSTONE HEALTH PLAN CENT
PA
01
—
991B
GEISINGER HEALTH PLAN
PA
01
—
DB8968
RAILROAD MEDICARE
PA
Enumeration date
02/19/2007
Last updated
08/22/2020
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