Individual
ARELYS ITWARU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
4655 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2579
(631) 331-2424
Mailing address
1527 PINE ACRES BLVD, BAY SHORE, NY 11706-2427
(631) 889-4251
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
746026
NY
164W00000X
Licensed Practical Nurse
Primary
306546
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F407163-01
NY
Other
Enumeration date
07/30/2014
Last updated
04/13/2026
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