MEDICARE: SAM PARKER FREMONT LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	356041	NY

General Provider Information

NPI Number	:	1396672630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAM PARKER FREMONT LPN

Provider Business Mailing Address
First Line	:	58 PORTION RD UNIT 52
Second Line	:
City	:	LAKE RONKONKOMA
State	:	NY
Zip	:	11779-4177
Country	:	US
Telephone Number	:	631-459-1158
Fax Number	:

Provider Business Practice Location Address
First Line	:	58 PORTION RD UNIT 52
Second Line	:
City	:	LAKE RONKONKOMA
State	:	NY
Zip	:	11779-4177
Country	:	US
Telephone Number	:	631-459-1158
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/08/2026

Similar Medicare Providers

1891976452 — MRS. ELIZABETH TREAT MORRIS P.T.
Practice Location Address:

4177 MATHEWS WAY
SALT LAKE CITY, UT
84124-4021

Practice Phone: 801-272-3118
Practice Fax: 801-277-9724

1568759488 — WELLINGTON MSL, LLC
Practice Location Address:

4522 S 1300 E
SALT LAKE CITY, UT
84117-4177

Practice Phone: 801-281-3477
Practice Fax: 801-268-1854

1588163869 — SSSHT OPCO 4522 S 1300 E LLC
Practice Location Address:

4522 S 1300 E
SALT LAKE CITY, UT
84117-4177

Practice Phone: 801-281-3477
Practice Fax:

1447826045 — JEREMY KLEBBA MOTR/L
Practice Location Address:

50 N MEDICAL DR
SALT LAKE CITY, UT
84132-4177

Practice Phone: 801-581-2121
Practice Fax:

1861138893 — LISA MARIE SCHIFF
Practice Location Address:

4522 S 1300 E
SALT LAKE CITY, UT
84117-4177

Practice Phone: 385-743-2171
Practice Fax:

1447953948 — YAIMA LORENZO SANCHEZ
Practice Location Address:

4177 MILNER CIR APT 306
LAKE WORTH, FL
33463-8178

Practice Phone: 561-255-0980
Practice Fax:

Directions to “ SAM PARKER FREMONT LPN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.