Provider Demographics
NPI:1619859618
Name:ITWARU, RACHAEL PRIYA
Entity type:Individual
Prefix:
First Name:RACHAEL PRIYA
Middle Name:
Last Name:ITWARU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PRIYA
Other - Middle Name:
Other - Last Name:MAHADEO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:85 PIPING ROCK RD
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-2805
Mailing Address - Country:US
Mailing Address - Phone:718-869-4974
Mailing Address - Fax:
Practice Address - Street 1:85 PIPING ROCK RD
Practice Address - Street 2:
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-2805
Practice Address - Country:US
Practice Address - Phone:718-869-4974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula