Individual ProviderGeraldine Mary La GruaPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address59 Rolling Hill Grn, Staten Island, NY 10312-1808(718) 948-3161PECOS EnrollmentBased on the most recent information from CMS, provider Geraldine Mary La Grua does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1205142619Provider TypeIndividualFull NameLa Grua, Geraldine MaryTitleMrs.CredentialPHYSICAL THERAPISTGenderFemaleSole ProprietorNoEnumeration Date8/23/2010Last Updated8/23/2010Contact InformationPractice LocationPractice Address59 Rolling Hill Grn, Staten Island, NY 10312-1808Phone(718) 948-3161FaxUnlisted FaxMailing LocationMailing Address59 Rolling Hill Grn, Staten Island, NY 10312-1808Phone(718) 948-3161FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense40QA00986300New Jersey