Organization
PENROSE DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROLIN PENROSE MD (DERMATOLOGIST)
(917) 620-4421
Entity
Organization
Contact information
Practice address
1110 SOUTH AVE, SUITE 400, STATEN ISLAND, NY 10314-3403
(917) 830-1415
(917) 830-1418
Mailing address
1110 SOUTH AVE, SUITE 400, STATEN ISLAND, NY 10314-3403
(917) 830-1415
(917) 830-1418
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
245597-1
NY
Other
Enumeration date
03/17/2016
Last updated
06/28/2016
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