Individual
GENGO SUNAGAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140
(215) 707-8484
(215) 707-3946
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-9724
(215) 707-3677
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
LT000773
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD463661
PA
Other
Enumeration date
08/18/2017
Last updated
01/31/2019
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