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

Carolin T Penrose, MD

Individual provider Dermatology Physician · NPI 1790946655

Carolin T Penrose, MD is a Dermatology in Staten Island, New York. Graduated from New York Medical College in 2006, 20 years ago. Accepts Medicare assignment. Licensed in New York.

Years since qualifying
20
Trained at
New York Medical College
Licensed in
NY
In the registry since
2008
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1110 S Ave Ste 400
Staten Island, NY 10314-3411
Phone: (917) 830-1415
Fax: (917) 830-1418
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 245597 (NY)

Record details

NPI number1790946655
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 23, 2008
Last updated in NPPESJune 10, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolNEW YORK MEDICAL COLLEGE
Graduated 2006 (20 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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