Provider Demographics
NPI:1710080619
Name:COHEN, LEONARD (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2227
Mailing Address - Country:US
Mailing Address - Phone:860-233-6293
Mailing Address - Fax:
Practice Address - Street 1:928 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2227
Practice Address - Country:US
Practice Address - Phone:860-233-6293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT023307207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTHAS432OtherOXFORD
CT023307OtherPHCS
CT050427OtherCONNECTICARE
CT0P0430OtherHEALTHNET
CT0041618OtherAETNA
CT01023307OtherCIGNA
CT00100570OtherUNITED
CT010023307CT02OtherANTHEM
CT023307OtherPHCS