Provider Demographics
NPI:1821072000
Name:COHEN, LESLIE V (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:V
Last Name:COHEN
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:PO BOX 29389
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23242-0389
Mailing Address - Country:US
Mailing Address - Phone:804-288-2800
Mailing Address - Fax:804-288-4800
Practice Address - Street 1:9900 INDEPENDENCE PARK DR STE 110
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1486
Practice Address - Country:US
Practice Address - Phone:804-288-2800
Practice Address - Fax:804-288-4800
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012365092086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010104718Medicaid
VAP00185789OtherRR MEDICARE
VAP00185789OtherRR MEDICARE
VAF63484Medicare UPIN
P00185789Medicare PIN