Provider Demographics
NPI:1205849395
Name:BUCHNESS, MARY RUTH (MD)
Entity type:Individual
Prefix:
First Name:MARY RUTH
Middle Name:
Last Name:BUCHNESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 MOUNTAIN VIEW RD W
Mailing Address - Street 2:
Mailing Address - City:ASBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08802-1027
Mailing Address - Country:US
Mailing Address - Phone:484-503-7546
Mailing Address - Fax:
Practice Address - Street 1:279 NJ ROUTE 31
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-4098
Practice Address - Country:US
Practice Address - Phone:484-503-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY156839207N00000X
PAMD487467207N00000X
NJ25MA12458200207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MB046F4010Medicare ID - Type Unspecified
E49772Medicare UPIN