Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Kyle William Canavally Jr., ATC

Individual provider Athletic Trainer · NPI 1467172205

Mr. Kyle William Canavally Jr., ATC is an Athletic Trainer in Brockport, New York. Licensed in New York. Registered with an NPI since 2022.

Licensed in
NY
In the registry since
2022
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

350 New Campus Dr
Brockport, NY 14420-2914
Phone: (585) 395-5374
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 004413 (NY)

Record details

NPI number1467172205
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorNo
NPI enumeratedAugust 31, 2022
Last updated in NPPESAugust 31, 2022
Certification dateAugust 31, 2022

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