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TISA A AYUSO D.O.
Child & Adolescent Psychiatry >> Psychiatry & Neurology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1851629448
Individual Registrant: TISA A AYUSO D.O.
Gender: F
Sole Proprietor
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
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
Tel: 203-863-3944 Fax: 203-863-4690
Registration Information:
NPI: 1851629448
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 2084P0804X | Allopathic & Osteopathic Physicians Psychiatry & Neurology Child & Adolescent Psychiatry | CT | 048692 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 004041000 | CT | 05 | |
| 008022622 | CT | 05 | |
| 008039241 | CT | 05 | |
| 008001325 | CT | 05 | |
| 008003745 | CT | 05 | |
| 008039745 | CT | 05 | |
| 004082260 | CT | 05 | |
| 008022626 | CT | 05 |
