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

Mr. Michael Joseph Moore, LAT

Individual provider Athletic Trainer · NPI 1811639321

Mr. Michael Joseph Moore, LAT is an Athletic Trainer in Madison, New Jersey. Practices as a sole proprietor. Licensed in New Jersey.

Licensed in
NJ
In the registry since
2022
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

170 Ridgedale Ave
Madison, NJ 07940-1295
Phone: (973) 593-3117
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 25MT00285700 (NJ)

Record details

NPI number1811639321
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT
Sole proprietorYes
NPI enumeratedApril 13, 2022
Last updated in NPPESApril 13, 2022
Certification dateApril 13, 2022
Mailing address1001 Whispering Way Apt 193, Aberdeen, NJ 07747-1983

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