Healthcare Provider Details

I. General information

NPI: 1568533438
Provider Name (Legal Business Name): C RENEE WASHINGTON-HYDE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. CHARMETRA RENEE WASHINGTON-HYDE

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 499
ESTERO FL
33929-0499
US

IV. Provider business mailing address

PO BOX 499
ESTERO FL
33929-0499
US

V. Phone/Fax

Practice location:
  • Phone: 516-343-2419
  • Fax:
Mailing address:
  • Phone: 516-343-2419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number38103
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME102790
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number237632
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD-25662
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: