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Export Provider Record NPI 1053353680
Gail Holly MautnerMD
Active
NPI Number1053353680
NPI TypeNPI-1 Individual
SpecialtyDermatology
Provider Details
NPI1053353680
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2006-06-11
Last Updated2013-02-18
Mailing Address12 East Willow Street
Millburn, NJ 07041
United States
Phone: (973) 376-8500 | Fax: (973) 376-1820
📍 View Map
Primary Practice Address12 East Willow Street
Millburn, NJ 07041
United States
Phone: (973) 376-8500 | Fax: (973) 376-1820
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No207N00000X – DermatologyNJMA62201
Yes207N00000X – DermatologyNJ25MA06220100
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About NPI 1053353680

Gail Holly Mautner MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1053353680. The primary specialty listed is Dermatology. The provider is located in Millburn, NJ. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-06-11. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1053353680?

NPI 1053353680 belongs to Gail Holly Mautner MD, a Dermatology in Millburn, NJ. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1053353680 active?

The current status of NPI 1053353680 in the NPPES registry is Active. The record was last updated on 2013-02-18.

What specialty is NPI 1053353680?

NPI 1053353680 is classified under the taxonomy Dermatology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1053353680?

You can verify NPI 1053353680 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1053353680?

The primary practice address on file for NPI 1053353680 is 12 East Willow Street, Millburn, NJ 07041. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1053353680 issued?

NPI 1053353680 was first issued (enumerated) on 2006-06-11. The NPPES record was last updated on 2013-02-18.

Practice Location Map

Gail Holly Mautner is located at 12 East Willow Street, Millburn, NJ. Use the map below to find directions or verify the practice location.

📍 12 East Willow Street, Millburn, NJ 07041  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Gail Holly Mautner. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1053353680. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
DermatologyMA62201NJ
Dermatology25MA06220100NJ
Data Verified from CMS NPPES Last synced: 2026-06-14 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162