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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PETER BOURQUE NP LLC
NPI 1629810585
Nurse Practitioner - Psychiatric/Mental Health in Bohemia, NY

Active since June 11, 2024
1650 SYCAMORE AVE STE 39, BOHEMIA, NY 11716(631) 213-1770(631) 315-8042 Get Directions Write a Review

NPPES record last updated: October 1, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Oct 1, 2026, Jan 31, 2026, Jan 15, 2026 and 2 more (5 updates tracked since 2024).

About Peter Bourque Np Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PETER BOURQUE NP LLC (NPI 1629810585), doing business as Peter Bourque Np, is a healthcare organization registered as a psychiatric/mental health in Bohemia, New York and active in the NPI registry since June 2024. The organization lists Peter Ralph Bourque, Owner, as its authorized official.

NPPES Registry Identity

NPI1629810585
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NamePETER BOURQUE NP LLC
Location Address1650 SYCAMORE AVE STE 39Bohemia, NY 11716-1736
Mailing Address1650 Sycamore Ave Ste 39Bohemia, NY 11716-1736 · (631) 213-1770 · Fax (631) 315-8042
Phone(631) 213-1770
Fax(631) 315-8042
Organization SubpartNo
Authorized OfficialPeter Ralph BourqueOwner · (631) 213-1770
Enumeration DateJune 11, 2024
Last NPPES UpdateOctober 1, 20265 updates tracked since enumeration
NPPES CertifiedOctober 1, 2026
✔ NPI 1629810585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
1650 SYCAMORE AVE STE 39, Bohemia, NY 11716
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Other Names 1

Doing Business AsPeter Bourque Np

Other Identifiers 1

Other9957957NY · Aetna

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTINE MENNA LCAT
Counselor
1650 SYCAMORE AVE STE 39
BOHEMIA, NY 11716
Suffolk County (631) 758-8290
MS. MONIKA CHARLOTTE PAULUS
Counselor (Mental Health)
1650 SYCAMORE AVE STE 39
BOHEMIA, NY 11716
Suffolk County (631) 758-8290
DANIEL WOODS
Counselor (Mental Health)
1650 SYCAMORE AVE STE 39
BOHEMIA, NY 11716
Suffolk County (631) 758-8290
MRS. STEPHANIE-ANN NICOLE MCDOWELL LMHC
Counselor (Mental Health)
1650 SYCAMORE AVE STE 39
BOHEMIA, NY 11716
Suffolk County (631) 758-8290
HAILEY MARIE MANCINI MHC
Counselor (Mental Health)
1650 SYCAMORE AVE STE 39
BOHEMIA, NY 11716
Suffolk County (631) 758-8290
LARINA ARIEL ARCESE
Counselor (Mental Health)
1650 SYCAMORE AVE STE 39
BOHEMIA, NY 11716
Suffolk County (631) 758-8290
RONALD PATRICK VILLANO LMHC-D
Counselor (Mental Health)
1650 SYCAMORE AVE STE 39
BOHEMIA, NY 11716
Suffolk County (631) 758-8290
MR. MAURICE LAMONT MEEKS JR.
Counselor (Mental Health)
1650 SYCAMORE AVE STE 39
BOHEMIA, NY 11716
Suffolk County (631) 758-8290

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peter Bourque Np LLC's NPI number?

The NPI number for Peter Bourque Np LLC is 1629810585. It was assigned to this organization in the NPPES registry on June 11, 2024. The provider is doing business as Peter Bourque Np.

Where is Peter Bourque Np LLC located?

Peter Bourque Np LLC is located at 1650 Sycamore Ave Ste 39, Bohemia, NY 11716. The listed phone number is (631) 213-1770.

What is Peter Bourque Np LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Peter Bourque Np LLC was last updated on October 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.