Gail Holly Mautner
Dermatologist
12 East Willow Street
Millburn
, New Jersey 07041
Gail Holly Mautner
Dermatologist
12 East Willow Street
Millburn
, New Jersey 07041
(973) 376-1820
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Gail Holly Mautner
- 12 East Willow Street
- Millburn, NJ
- Zip : 07041
- Fax : (973) 376-1820
- Phone : (973) 376-8500
Second Address
- Gail Holly Mautner
- 12 East Willow Street
- Millburn, NJ
- Zip : 07041
- Fax : (973) 376-1820
- Phone : (973) 376-8500
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Is Gail Holly Mautner a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 25MA06220100 | NJ |
| N | 207N00000X | Dermatologist | MA62201 | NJ |
National Provider Identifier
| NPI | 1053353680 |
|---|---|
| Provider Name | Gail Holly Mautner |
| First Address | Millburn, NJ 07041 |
| Second Address | Millburn, NJ 07041 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/06/2006 |
| Last Update Date | 18/02/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| G06604 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.