Provider Demographics
NPI:1952470676
Name:COZZENS, DENNIS THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:THOMAS
Last Name:COZZENS
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 1:1707 OSAGE ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-2607
Mailing Address - Country:US
Mailing Address - Phone:703-824-8248
Mailing Address - Fax:703-824-8212
Practice Address - Street 1:1707 OSAGE ST
Practice Address - Street 2:SUITE 404
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-2607
Practice Address - Country:US
Practice Address - Phone:703-824-8248
Practice Address - Fax:703-824-8212
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010380312084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA224525OtherANTHAM
VA110806OtherKAISER PERMANENTE
VA224524OtherANTHAM
VA063693OtherVALUE OPTIONS