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Contact Information

LIDIYA BUKENOVA
90 BRICK ROAD, FLOOR 3
MARLTON, NJ08053
 Phone: 856-355-6000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospitalist

208M00000X
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for LIDIYA BUKENOVA · (Female)

NPI Number 1518498088
Status Active
Credentials
Entity Individual
Enumeration date 03/25/2017
Last updated 03/31/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • NJ License # 25MA11707000
  • PA License # MD471032
Hospital affiliation(s)
  • WILKES-BARRE GENERAL HOSPITAL - (Acute Care)
    575 NORTH RIVER STREET
    WILKES-BARRE, PA 18764
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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