Healthcare Provider Details

I. General information

NPI: 1750453239
Provider Name (Legal Business Name): EMILY T. SUVOCK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/09/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 GREENVIEW DR STE 445
STATE COLLEGE PA
16803-2106
US

IV. Provider business mailing address

155 WELLNESS WAY
STATE COLLEGE PA
16803-6702
US

V. Phone/Fax

Practice location:
  • Phone: 814-278-4631
  • Fax: 814-278-4685
Mailing address:
  • Phone: 814-231-7000
  • Fax: 814-231-7098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS013809
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberOS013809
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: