Provider Demographics
NPI:1619466273
Name:PITT, NICHOLAS BRIKASH
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:BRIKASH
Last Name:PITT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6686
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30604-6686
Mailing Address - Country:US
Mailing Address - Phone:706-850-9660
Mailing Address - Fax:
Practice Address - Street 1:59 W CANDLER ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-2558
Practice Address - Country:US
Practice Address - Phone:706-850-9660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS000930237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist