Individual
ELIZABETH CACCAVALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
622 W 168TH ST PH 11, NEW YORK, NY 10032-3720
(914) 787-2279
Mailing address
622 W 168TH ST PH 11, NEW YORK, NY 10032-3720
(914) 787-2279
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000050739
MD
2255A2300X
Athletic Trainer
—
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
AL
Other
Enumeration date
10/05/2021
Last updated
09/16/2025
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