Healthcare Provider Details

I. General information

NPI: 1780609701
Provider Name (Legal Business Name): SUZANNE GREB D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7095 WESTBRANCH HWY STE 1100
LEWISBURG PA
17837-6864
US

IV. Provider business mailing address

ONE HOSPITAL DRIVE SUITE 306
LEWISBURG PA
17837-9315
US

V. Phone/Fax

Practice location:
  • Phone: 570-524-5050
  • Fax: 570-524-5250
Mailing address:
  • Phone: 570-522-4110
  • Fax: 570-768-3911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS008143L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: