Provider Demographics
NPI:1104116144
Name:SENSATIONAL ACHIEVEMENTS, LLC
Entity type:Organization
Organization Name:SENSATIONAL ACHIEVEMENTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMALLE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:347-426-6107
Mailing Address - Street 1:59 MAPLE TREE AVE
Mailing Address - Street 2:APT C
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06906-2260
Mailing Address - Country:US
Mailing Address - Phone:203-200-7256
Mailing Address - Fax:646-626-7586
Practice Address - Street 1:1011 HIGH RIDGE RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1610
Practice Address - Country:US
Practice Address - Phone:203-200-7256
Practice Address - Fax:646-626-7586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003406174400000X, 261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty