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

Individual provider Physician Assistant · NPI 1912160904

Leslie Sormillon-Potenciano is a Physician Assistant in Staten Island, New York. Qualified in 1999, 27 years ago. Practices with Amboy Medical Practice PC, a 173-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
27
Licensed in
NY
In the registry since
2008
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Practice location Address checks out

355 Bard Ave
Staten Island, NY 10310-1664
Phone: (718) 818-1070
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 007061-1 (NY)

Record details

NPI number1912160904
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 9, 2008
Last updated in NPPESJuly 9, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Amboy Medical Practice Pc — 173 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Staten Island