Provider Demographics
NPI:1225438963
Name:CLAURE- MCNAMEE, VIVIANA INGRID (MD)
Entity type:Individual
Prefix:
First Name:VIVIANA
Middle Name:INGRID
Last Name:CLAURE- MCNAMEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VIVIANA
Other - Middle Name:CLAURE
Other - Last Name:FORTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:703 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2691
Mailing Address - Country:US
Mailing Address - Phone:973-754-2000
Mailing Address - Fax:
Practice Address - Street 1:703 MAIN ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2691
Practice Address - Country:US
Practice Address - Phone:973-754-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09899400208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0548715Medicaid