Individual
ANNE K. PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
632 BROADWAY PH, NEW YORK, NY 10012-2614
(800) 731-4254
Mailing address
4812 GREYWOOD LN, SARASOTA, FL 34235-5602
(412) 310-0638
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2014-00719
NC
207Q00000X
Family Medicine Physician
A94402
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A944020
—
CA
Enumeration date
11/01/2006
Last updated
04/23/2026
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