Individual ProviderMartha Camacho-LuquePhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4434 Amboy Rd, Staten Island, NY 10312-3845(718) 227-7015(631) 580-5200PECOS EnrollmentBased on the most recent information from CMS, provider Martha Camacho-Luque 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 ID1487921219Provider TypeIndividualFull NameCamacho-Luque, MarthaCredentialDPTGenderFemaleSole ProprietorNoEnumeration Date11/22/2011Last Updated11/22/2011Contact InformationPractice LocationPractice Address4434 Amboy Rd, Staten Island, NY 10312-3845Phone(718) 227-7015Fax(718) 227-6411Mailing LocationMailing Address4175 Veterans Memorial Hwy, Suite 202, Ronkonkoma, NY 11779-7639Phone(631) 580-5200Fax(631) 580-5222Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense026311New York