Individual ProviderJeremiah Jacob TomStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1561 Long Pond Rd Ste 206, Rochester, NY 14626-4135(585) 368-4800PECOS EnrollmentBased on the most recent information from CMS, provider Jeremiah Jacob Tom 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 2 days ago.Profile DetailsProvider ID1235814781Provider TypeIndividualFull NameTom, Jeremiah JacobCredentialMDGenderMaleSole ProprietorNoEnumeration Date6/21/2023Last Updated6/21/2023Contact InformationPractice LocationPractice Address1561 Long Pond Rd Ste 206, Rochester, NY 14626-4135Phone(585) 368-4800Fax(585) 368-4815Mailing LocationMailing Address1561 Long Pond Rd Ste 206, Rochester, NY 14626-4135Phone(585) 368-4800Fax(585) 368-4815Provider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer