Provider Demographics
NPI:1134121981
Name:BUONO, LEE M (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:M
Last Name:BUONO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CAPITAL WAY STE 456
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2521
Mailing Address - Country:US
Mailing Address - Phone:609-537-7300
Mailing Address - Fax:609-537-7301
Practice Address - Street 1:2 CAPITAL WAY
Practice Address - Street 2:SUITE 456
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2521
Practice Address - Country:US
Practice Address - Phone:609-537-7300
Practice Address - Fax:609-537-7301
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7319207T00000X
PAMD070105L207T00000X
NJ25MA08685200207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR152452001Medicaid
OK200023050AMedicaid
AR82627OtherBLUE CROSS ARKANSAS
179117500OtherU S DEPT OF LABOR
NJ0242667Medicaid
TX169004201Medicaid
AR18383000000OtherQUALCHOICE
AR82627OtherBLUE CROSS
82627OtherFIRST PYRAMID LIFE
MDL7319OtherWORKERS' COMPENSATION
TX8K5493OtherBLUE CROSS TEXAS
169004201OtherINDIGENT HEALTH CARE
TX5575000001OtherCIGNA GOVERNMENT SRV
TX8K5493OtherBLUE CROSS
TX1871793307OtherCIGNA DME#
TXP00062282OtherRAILROAD MEDICARE
TX5575000001OtherCIGNA GOVERNMENT SRV
OK200023050AMedicaid
AR18383000000OtherQUALCHOICE
MDL7319OtherWORKERS' COMPENSATION