Provider Demographics
NPI:1487150777
Name:JACOB, ARUN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ARUN
Middle Name:
Last Name:JACOB
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1207
Mailing Address - Country:US
Mailing Address - Phone:516-582-4028
Mailing Address - Fax:
Practice Address - Street 1:141 WEST LINCOLN HIGHWAY
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2615
Practice Address - Country:US
Practice Address - Phone:610-363-1008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-00004242183500000X
DCPH100001224183500000X
PARP452134183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist