Healthcare Provider Details

I. General information

NPI: 1447793625
Provider Name (Legal Business Name): JACOB CHARLES REASER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4311 EASTON AVE
BETHLEHEM PA
18020-1431
US

IV. Provider business mailing address

4311 EASTON AVE
BETHLEHEM PA
18020-1431
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-7410
  • Fax: 866-436-6461
Mailing address:
  • Phone: 484-526-7410
  • Fax: 866-436-6461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number067280
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH236079
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP451211
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: