Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PETER BOURQUE NP LLC
Active
Organization
PETER BOURQUE NP LLC
Active
Other names
PETER BOURQUE NP
Organization subpart
No
Provider details
NPI number
Authorized official
PETER RALPH BOURQUE JR. PMHNP-BC (OWNER)
(631) 213-1770
Entity
Organization
Contact information
Practice address
1650 SYCAMORE AVE STE 39, BOHEMIA, NY 11716-1736
(631) 213-1770
(631) 315-8042
Mailing address
1650 SYCAMORE AVE STE 39, BOHEMIA, NY 11716-1736
(631) 213-1770
(631) 315-8042
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/11/2024
Last updated
10/01/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers