Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Penrose Dermatology PLLC

Organization Medical Specialty Clinic/Center · NPI 1346601333

Penrose Dermatology PLLC is a Medical Specialty Clinic/Center in Staten Island, New York. Licensed in New York. Registered with an NPI since 2016.

Licensed in
NY
In the registry since
2016
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1110 S Ave Ste 400
Staten Island, NY 10314-3403
Phone: (917) 830-1415
Fax: (917) 830-1418
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence 245597-1 (NY)

Record details

NPI number1346601333
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carolin Penrose — Dermatologist · (917) 620-4421
NPI enumeratedMarch 17, 2016
Last updated in NPPESJune 28, 2016
Mailing address1110 South Ave, Suite 400, Staten Island, NY 10314-3403

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