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TISA A AYUSO D.O.

Child & Adolescent Psychiatry >> Psychiatry & Neurology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1851629448

Individual Registrant:
 TISA A AYUSO D.O.
Gender: F
Sole Proprietor

Location and contact information for practice:
5 PERRYRIDGE RD  GREENWICH, CT 06830-4697 US
Tel: 203-863-3944  Fax: 203-863-4690

Contact information for business:
5 PERRYRIDGE RD  GREENWICH, CT 06830-4697 US
Tel: 203-863-3944  Fax: 203-863-4690

Registration Information:
NPI: 1851629448
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2084P0804XAllopathic & Osteopathic Physicians
Psychiatry & Neurology
Child & Adolescent Psychiatry
CT048692

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
004041000CT05
008022622CT05
008039241CT05
008001325CT05
008003745CT05
008039745CT05
004082260CT05
008022626CT05




HEALTH CARE JOBS CT - Page 1



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