Individual
TISA A AYUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
8915 W CONNELL AVE, MILWAUKEE, WI 53226-3067
(414) 266-2932
Mailing address
5 PERRYRIDGE RD, GREENWICH, CT 06830-4697
(203) 863-3944
(203) 863-4690
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
048692
CT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
2706-321
WI
2084P0804X
Child & Adolescent Psychiatry Physician
73136
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004041000
—
CT
05
—
004082260
—
CT
05
—
008001325
—
CT
05
—
008003745
—
CT
05
—
008022622
—
CT
05
—
008022626
—
CT
05
—
008039241
—
CT
05
—
008039745
—
CT
Enumeration date
11/20/2009
Last updated
07/02/2025
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