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

Individual provider Athletic Trainer · NPI 1538944400

Tanner Caccavale, MS, LAT, ATC is an Athletic Trainer in Freehold, New Jersey. Licensed in New Jersey. Registered with an NPI since 2023.

Licensed in
NJ
In the registry since
2023
What do these letters mean?
MS — Master of Science
A graduate science degree.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

210 Mounts Corner Dr
Freehold, NJ 07728-2547
Phone: (732) 724-2433
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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 25MT00319600 (NJ)

Record details

NPI number1538944400
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , LAT , ATC
Sole proprietorNo
NPI enumeratedAugust 29, 2023
Last updated in NPPESAugust 29, 2023
Certification dateAugust 11, 2023

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