Provider Demographics
NPI:1477335867
Name:BACHAR, TOM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TOM
Middle Name:
Last Name:BACHAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 S UNIVERSITY DR STE 206
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4001
Mailing Address - Country:US
Mailing Address - Phone:954-662-0295
Mailing Address - Fax:
Practice Address - Street 1:1333 S UNIVERSITY DR STE 206
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-4001
Practice Address - Country:US
Practice Address - Phone:954-662-0295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11962103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical