Provider Demographics
NPI:1508603853
Name:LEE, SYDNEY ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:ELIZABETH
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
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Other - Credentials:
Mailing Address - Street 1:10443 BEACON LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-9743
Mailing Address - Country:US
Mailing Address - Phone:317-373-3617
Mailing Address - Fax:
Practice Address - Street 1:860 E 86TH ST STE 2
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-6860
Practice Address - Country:US
Practice Address - Phone:317-848-7755
Practice Address - Fax:317-848-7766
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18004525A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist