Provider Demographics
NPI:1790778371
Name:MATTERN, JOY C (PA-C)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:C
Last Name:MATTERN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:C
Other - Last Name:HARTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1700 OLD GATESBURG RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2276
Mailing Address - Country:US
Mailing Address - Phone:814-237-3122
Mailing Address - Fax:814-237-4050
Practice Address - Street 1:1700 OLD GATESBURG RD
Practice Address - Street 2:SUITE 310
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2276
Practice Address - Country:US
Practice Address - Phone:814-237-3122
Practice Address - Fax:814-237-4050
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051358363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical