MEDICARE: MRS. KATHLEEN ALICIA DELEWSKI PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA001064	ME

General Provider Information

NPI Number	:	1407903339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHLEEN ALICIA DELEWSKI PA-C

Provider Business Mailing Address
First Line	:	60 SHERMAN ST APT 1
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04101-2204
Country	:	US
Telephone Number	:	207-773-1131
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 SPRUCE ST
Second Line	:
City	:	SANFORD
State	:	ME
Zip	:	04073-2917
Country	:	US
Telephone Number	:	207-290-6900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	10/09/2025

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Directions to “ MRS. KATHLEEN ALICIA DELEWSKI PA-C” Practice Location

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