GENGO SUNAGAWA (NPI# 1255857504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255857504 |
| Entity Type | Individual |
| Full Name | GENGO SUNAGAWA |
| Credential | MD |
| Practice Address |
3509 N Broad St Philadelphia PA 19140 |
| Mailing Address |
2450 W Hunting Park Ave Philadelphia PA 19129-1302 |
| Practice Telephone | 2157078484 |
| Practice Fax Number | 2157073946 |
| Mailing Telephone | 2157079724 |
| Mailing Fax Number | 2157073677 |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2019-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | MD463661 | PA | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | LT000773 | PA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3401 N. Board Street, 3rd Floor, Zone C, Suite 301, Division of Cardiovascular Surgery, Philadelphia, PA 19140 | 2678048016 |
| Street Address |
3509 N BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669466793 | Riyaz Bashir | Internal Medicine | 3509 N Broad St, Philadelphia, PA 19140-5103 | 2005-09-05 |
| 1750841151 | Chloe Beiler | Physician Assistant | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2019-03-21 |
| 1770068041 | Chirantan Vinodbhai Mangukia | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-10-02 |
| 1891278933 | Temple Faculty Practice Plan, Inc | Speech-Language Pathologist | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-14 |
| 1396228508 | Temple Faculty Practice Plan, Inc | Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-13 |
| 1992288112 | Temple Faculty Practice Plan, Inc | Urology | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-13 |
| 1023591781 | Temple Faculty Practice Plan, Inc | Otolaryngology | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| 1154804839 | Temple Faculty Practice Plan, Inc | Physical Therapist | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| 1902389646 | Temple Faculty Practice Plan, Inc | Neurological Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| 1245713908 | Temple Faculty Practice Plan, Inc | Orthopaedic Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640519 | Desirea Grant | Registered Nurse | 2000 W. Venango Street, Phila, PA 19140 | 2020-08-19 |
| 1306316104 | Carmen Doumit | Dentist | 3223 N Broad Street, Temple University Department of Orthodontics, Philadelphia, PA 19140 | 2018-12-05 |
| 1780150375 | Samantha Marina Felix | Counselor | 3803-3805 N 5th St, Philadelphia, PA 19140 | 2018-10-22 |
| 1518485135 | Holly Marie Barbee | Dietitian, Registered | 4417 N 6th St., Philadelphia, PA 19140 | 2017-09-04 |
| 1033630892 | Jessica Anne Tang | Otolaryngology | 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 | 2017-07-03 |
| 1710416870 | Narsis Aminian | Internal Medicine | 3401 N Broad Street, Temple Hospital, Neurlogy Deartment, Philadelphia, PA 19140 | 2017-06-12 |
| 1629527338 | Alaa Khatib | Pharmacist | 4616-4650 N. Broad Street, Philadelphia, PA 19140 | 2016-09-23 |
| 1548716160 | Direct Home Health Care | In Home Supportive Care | 3550 N 9th St, Philadelphia, PA 19140 | 2016-09-01 |
| 1306399225 | Zaima Choudhry | Student in an Organized Health Care Education/Training Program | Department of Pulmonary and Sleep Medicine, 3401 North Broad Street, Zone C - 7th Floor, Philadelphia, PA 19140 | 2016-07-27 |
| 1891145504 | Saji Mathew | Pharmacist | 4530n 5th Street, Philadelphia, PA 19140 | 2016-06-14 |
| Find all providers in zip 19140 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528443041 | Michael Ibrahim | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3701 Chestnut St Apt 410, Philadelphia, PA 19104-3104 | 2015-07-27 |
| 1215279112 | Jeffrey M Dunn | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 W. Washington Sq, #1207, Philadelphia, PA 19106 | 2013-03-19 |
| 1124200167 | Charles Tanos Bakhos | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3509 N. Broad St, Philadelphia, PA 19140 | 2007-12-01 |
| 1548303464 | Srikrishna Sirivella | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Erie Ave & Front Street, St.christopher's Hospital for Children, Cardiothoracic, Philadelphia, PA 19134-1095 | 2007-02-14 |
| 1114943644 | Raphael Chun-sing Lui | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 151 W School House Ln, Philadelphia, PA 19144-3348 | 2006-07-15 |
| 1174167571 | Stc Pediatrics LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-30 |
| 1437793833 | Stc Pediatrics LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 230 N Broad St, Philadelphia, PA 19102-1121 | 2019-10-30 |
| 1255975652 | Stc Pediatrics LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5501 Old York Rd, Philadelphia, PA 19141-3018 | 2019-10-30 |
| 1629538228 | Benjamin Franklin Smood | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3400 Spruce Street, 4 Maloney, Department of Surgery, Surgery Education, Philadelphia, PA 19104 | 2019-03-21 |
| 1770068041 | Chirantan Vinodbhai Mangukia | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-10-02 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19140 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.