Provider Demographics
NPI:1942623566
Name:ABT, NICHOLAS BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:BRIAN
Last Name:ABT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 INDUSTRIAL DR STE 202
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3465
Mailing Address - Country:US
Mailing Address - Phone:508-539-2444
Mailing Address - Fax:
Practice Address - Street 1:5 INDUSTRIAL DR STE 202
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3465
Practice Address - Country:US
Practice Address - Phone:508-539-2444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1024774207Y00000X
NC2022-01438207Y00000X
NC25118207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty