Healthcare Provider Details

I. General information

NPI: 1023700507
Provider Name (Legal Business Name): ALYSSA MARGUERITE ROACH CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALYSSA MARGUERITE ROACH CNM

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 N MAIN ST STE 400
DUBLIN PA
18917-2107
US

IV. Provider business mailing address

124 N MAIN ST APT 3
COOPERSBURG PA
18036-1554
US

V. Phone/Fax

Practice location:
  • Phone: 215-536-3200
  • Fax:
Mailing address:
  • Phone: 484-274-9819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW010906
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: