Provider Demographics
NPI:1538472402
Name:TUIS, JIMENA (MD)
Entity Type:Individual
Prefix:
First Name:JIMENA
Middle Name:
Last Name:TUIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SYLVAN RD S
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4639
Mailing Address - Country:US
Mailing Address - Phone:203-514-7972
Mailing Address - Fax:203-533-4072
Practice Address - Street 1:3 SYLVAN RD S
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4639
Practice Address - Country:US
Practice Address - Phone:203-514-7972
Practice Address - Fax:203-533-4072
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2450062084P0800X
NY3272192084P0804X
CT0522682084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry