Provider Demographics
NPI:1154536480
Name:NANCY W BACHER PA
Entity type:Organization
Organization Name:NANCY W BACHER PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BACHER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:305-935-0540
Mailing Address - Street 1:2999 NE 191ST ST STE 705
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3386
Mailing Address - Country:US
Mailing Address - Phone:305-935-0540
Mailing Address - Fax:305-937-0625
Practice Address - Street 1:2999 NE 191ST ST STE 705
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3386
Practice Address - Country:US
Practice Address - Phone:305-935-0540
Practice Address - Fax:305-937-0625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3496103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3677Medicare ID - Type UnspecifiedGROUP NUMBER