Individual
DR. LEONID IGOREVICH BURUNCHENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1140 ROUTE 72 W, MANAHAWKIN, NJ 08050-2412
(609) 597-6011
Mailing address
15 ABINGDON AVE, MEDFORD, NJ 08055-3361
(267) 970-7209
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA11043200
NJ
207P00000X
Emergency Medicine Physician
309491
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2018
Last updated
11/29/2022
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