Provider Demographics
NPI:1407808298
Name:MARTYAK, WILLIAM J (PA-C)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:MARTYAK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-255-1712
Mailing Address - Fax:814-255-2961
Practice Address - Street 1:4108 CORTLAND DR
Practice Address - Street 2:BOX 367
Practice Address - City:NEW PARIS
Practice Address - State:PA
Practice Address - Zip Code:15554-7706
Practice Address - Country:US
Practice Address - Phone:814-839-4108
Practice Address - Fax:814-839-4845
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA003500L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical