Provider Demographics
NPI:1215346663
Name:LESLIE V COHEN MD PLASTIC AND RECONSTRUCTIVE SURGERY
Entity type:Organization
Organization Name:LESLIE V COHEN MD PLASTIC AND RECONSTRUCTIVE SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:V
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-288-2800
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 1:7110 FOREST AVE STE 101
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3787
Practice Address - Country:US
Practice Address - Phone:804-288-2800
Practice Address - Fax:804-288-4800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012365092086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty