Dr. John Jacob Daub IV, O.D.
Optometrist in Rutherford, NJ. Individual provider (NPI-1).
NPI number1396254751
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1396254751
- Entity type
- Individual (NPI-1)
- Name
- Dr. John Jacob Daub IV
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 28, 2017
- Certification date
- Jun 10, 2021
- Last updated
- Jul 21, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPTOMETRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 27OA00674800 | NJ | Yes |
Practice location
31 Park AveRutherford, NJ 07070-1711
Phone 201-939-2463
Mailing address
31 Park AveRutherford, NJ 07070-1711
Phone 201-939-2463
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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