Provider Demographics
NPI:1083712764
Name:AULETTO, ROXELLEN ANNTOINETTE (PNP, ANP-BC)
Entity type:Individual
Prefix:DR
First Name:ROXELLEN
Middle Name:ANNTOINETTE
Last Name:AULETTO
Suffix:
Gender:F
Credentials:PNP, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 N COLUMBUS BLVD APT TD418
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-1431
Mailing Address - Country:US
Mailing Address - Phone:707-333-9985
Mailing Address - Fax:
Practice Address - Street 1:174 ATTACK WING
Practice Address - Street 2:6001 E. MOLLOY ROAD
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13211
Practice Address - Country:US
Practice Address - Phone:315-454-6146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN09572100363LP0200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4231272OtherHORIZON BC BS OF NJ
NJ233710ANGOtherMEDICARE PTAN
NJ2633604Medicaid