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General NPI Number Information
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NPI Number | 1083712764
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Entity Type | Individual
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Provider Name | ROXELLEN ANNTOINETTE AULETTO PNP, ANP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 174 ATTACK WING 6001 E. MOLLOY ROAD
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City | SYRACUSE
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State | NY
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Zip | 13211
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Country | US
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Telephone | 315-454-6146
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Fax |
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Provider Business Mailing Address
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Address Line | 3 N COLUMBUS BLVD APT TD418
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City | PHILADELPHIA
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State | PA
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Zip | 19106-1431
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Country | US
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Telephone | 707-333-9985
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 26NN09572100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NN09572100
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License Number State | NJ
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