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

Lauris J. Petersen MD PC

Organization Family Medicine Physician · NPI 1659563989

Lauris J. Petersen MD PC is a Family Medicine Physician in Glenville, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

15 Glenridge Rd
Glenville, NY 12302-4520
Phone: (518) 399-0909
Fax: (518) 399-2640
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 213320 (NY)

Record details

NPI number1659563989
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lauris Petersen — Ceo/President · (518) 399-0909
Other names Glenridge Family Medicine
NPI enumeratedAugust 10, 2007
Last updated in NPPESAugust 10, 2007
Mailing address15 Glenridge Rd, Glenville, NY 12302-4520

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