Individual ProviderJacob Zachariah AzzawiStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address169 Riverside Dr, Binghamton, NY 13905-4246(216) 527-6084PECOS EnrollmentBased on the most recent information from CMS, provider Jacob Zachariah Azzawi 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 ID1881380111Provider TypeIndividualFull NameAzzawi, Jacob ZachariahGenderMaleSole ProprietorYesEnumeration Date4/11/2023Last Updated4/12/2023Contact InformationPractice LocationPractice Address169 Riverside Dr, Binghamton, NY 13905-4246Phone(216) 527-6084FaxUnlisted FaxMailing LocationMailing Address6610 Chaffee Ct Apt E-5, Brecksville, OH 44141-2489Phone(216) 527-6084FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer