Individual ProviderJacob LarsenStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address169 Riverside Dr, Binghamton, NY 13905-4246(607) 775-0760PECOS EnrollmentBased on the most recent information from CMS, provider Jacob Larsen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 32 days ago.Profile DetailsProvider ID1083507578Provider TypeIndividualFull NameLarsen, JacobCredentialDPMGenderMaleSole ProprietorYesEnumeration Date6/2/2025Last Updated6/2/2025Contact InformationPractice LocationPractice Address169 Riverside Dr, Binghamton, NY 13905-4246Phone(607) 775-0760FaxUnlisted FaxMailing LocationMailing Address169 Riverside Dr, Binghamton, NY 13905-4246PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer