Provider Demographics
NPI:1023808847
Name:INTOWN DRY EYE CARE LLC
Entity type:Organization
Organization Name:INTOWN DRY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:UDELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:917-596-6545
Mailing Address - Street 1:145 FELD AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3509
Mailing Address - Country:US
Mailing Address - Phone:404-968-9471
Mailing Address - Fax:
Practice Address - Street 1:125 CLAIREMONT AVE STE 485
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2558
Practice Address - Country:US
Practice Address - Phone:404-968-9471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty