Organization
MOUNT NITTANY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN ROACH (CFO)
(814) 234-6148
Entity
Organization
Contact information
Practice address
155 WELLNESS WAY, STATE COLLEGE, PA 16803-6702
(814) 231-7000
(814) 231-7098
Mailing address
155 WELLNESS WAY, STATE COLLEGE, PA 16803-6702
(814) 231-7000
(814) 231-7098
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
550301
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007466550017
—
PA
Enumeration date
12/01/2006
Last updated
05/14/2026
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