Basic Information
| Provider Information | |||||||||
| NPI: | 1780609701 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREB | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE HOSPITAL DRIVE | ||||||||
| Address2: | SUITE 306 | ||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178379315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705224110 | ||||||||
| FaxNumber: | 5707683911 | ||||||||
| Practice Location | |||||||||
| Address1: | 7095 WESTBRANCH HWY STE 1100 | ||||||||
| Address2: | |||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178376864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705245050 | ||||||||
| FaxNumber: | 5705245250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 06/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS008143L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 232809429 | 01 | PA | TRICARE | OTHER | 50041617 | 01 | PA | BLUE CROSS | OTHER | 8462C3AH | 01 | PA | GEISINGER | OTHER | 118438700 | 01 | PA | DEPARTMENT OF LABOR | OTHER | 0323100 | 01 | PA | KEYSTONE | OTHER | 36011 | 01 | PA | BLUE SHIELD | OTHER | C900 | 01 | PA | HEALTH AMERICA | OTHER |