Individual
LIDIYA BUKENOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 BRICK ROAD, FLOOR 3, MARLTON, NJ 08053
(856) 355-6000
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD471032
PA
208M00000X
Hospitalist Physician
Primary
25MA11707000
NJ
208M00000X
Hospitalist Physician
MD471032
PA
Other
Enumeration date
03/25/2017
Last updated
03/31/2025
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