MOUNT NITTANY MEDICAL CENTER NPI 1104991801

NPI Information

  • NPI: 1104991801
  • Provider Name: MOUNT NITTANY MEDICAL CENTER
  • Classification: Clinic/Center - 261QP3300X
  • Specialization: Pain
  • Entity Type: Organization
  • :
  • CLIA Number: 39D2041965
  • Address: 911 UNIVERSITY DR
    STATE COLLEGE, PA
    ZIP 16801
  • Phone: (814) 237-3360

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NPI Details

MOUNT NITTANY MEDICAL CENTER is a pain clinic center in State College, PA. MOUNT NITTANY MEDICAL CENTER NPI is 1104991801. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

911 UNIVERSITY DR
STATE COLLEGE, PA
ZIP 16801-626
Phone: (814) 237-3360

The provider's authorized official is Bryan Roach .
The authorized official title is Cfo and has the following contact phone number (814) 234-6148.

The CLIA number assigned to this NPI record is 39D2041965 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/21/2006 and was last updated on 4/10/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP3300XClinic/CenterPain550301PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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