Active NPI
Gino Bureau, PT
- Specialist
- Troy, NY
National Provider Identifier
1790760866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 007820-1
- Practice address
- 1 Conway CT
Troy, NY 12180-2108 - Phone
- (518) 273-4350
- Fax
- (518) 273-7350
- NPI assigned
- Dec 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 007820-1 | NY | Primary |
Addresses
Primary practice location
1 Conway CT
Troy, NY 12180-2108
Mailing address
1A West Dr
Castleton, NY 12033-9524
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7820 | NY | MD | Psychologist |
| 007820-1 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790760866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1A WEST DR",
"city": "CASTLETON",
"state": "NY",
"postal_code": "120339524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CONWAY CT",
"city": "TROY",
"state": "NY",
"postal_code": "121802108",
"telephone_number": "518-273-4350",
"fax_number": "518-273-7350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUREAU",
"first_name": "GINO",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-13",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "007820-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Troy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.