National Provider Identifier
Carolyn Diercksen
Carolyn Diercksen is listed in the NPPES registry with a primary specialty of Peer Specialist in Orchard Park, NY and a listed phone number of (716) 822-2117.
Profile Overview
- NPI
- 1912656828
- Provider Type
- Individual
- Primary Specialty
- Peer Specialist
- Enumeration Date
- March 20, 2022
- Last Updated
- March 20, 2022
Practice Location
- 3176 Abbott RD Unit 500
- Orchard Park, NY 14127-1069
Phone: (716) 822-2117
Specialties
- Peer Specialist (175T00000X)
Full Record
- NPI
- 1912656828
- Entity Type
- Individual
- Last Name
- Diercksen
- First Name
- Carolyn
- Mailing Street Address
- 3176 Abbott RD Unit 500
- Mailing City
- Orchard Park
- Mailing State
- NY
- Mailing ZIP Code
- 14127-1069
- Mailing Country
- US
- Mailing Phone
- (716) 822-2117
- Practice Street Address
- 3176 Abbott RD Unit 500
- Practice City
- Orchard Park
- Practice State
- NY
- Practice ZIP Code
- 14127-1069
- Practice Country
- US
- Practice Phone
- (716) 822-2117
- Enumeration Date
- March 20, 2022
- Last Updated
- March 20, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- March 20, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Peer Specialist (175T00000X)