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Organization

HOD ADVANCED CRANIAL PROSTHETICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. PORTIA SHELBY IVERY (CRANIAL PROSTHESIS SPECIALIST)
(585) 694-9175
Entity
Organization

Contact information

Practice address
345 LAKE AVE APT 4, ROCHESTER, NY 14608-1083
(585) 694-9175
(585) 694-9175
Mailing address
345 LAKE AVE APT 4, ROCHESTER, NY 14608-1083
(585) 694-9175
(585) 694-9175

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary

Other

Enumeration date
03/26/2026
Last updated
03/26/2026
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