Provider Demographics
NPI:1548374366
Name:HAMADA, RENEE MERELYN (PH D)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:MERELYN
Last Name:HAMADA
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 AMHERST DR
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1001
Mailing Address - Country:US
Mailing Address - Phone:516-569-4322
Mailing Address - Fax:516-569-7397
Practice Address - Street 1:124 FRANKLIN PL
Practice Address - Street 2:PENINSULA COUNSELING CENTER
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1203
Practice Address - Country:US
Practice Address - Phone:516-569-6600
Practice Address - Fax:516-374-2261
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0089301103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent