Individual
ANYA K DIERCKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
295 VARNUM AVE, LOWELL, MA 01854-2134
(978) 937-6161
Mailing address
361 COLUMBIA ST, APARTMENT 1, CAMBRIDGE, MA 02141-1311
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA4289
MA
Other
Enumeration date
02/01/2012
Last updated
02/01/2012
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