=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699890061
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIA LYNN SWAN-MOORE M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2007
-----------------------------------------------------
Last Update Date | 01/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 WEST ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10282-2198
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-902-2832
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 WEST ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10282-2198
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-902-2832
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2083P0500X
-----------------------------------------------------
Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
-----------------------------------------------------
License Number | 2021-02391
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2083P0500X
-----------------------------------------------------
Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
-----------------------------------------------------
License Number | 310999
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2083P0500X
-----------------------------------------------------
Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
-----------------------------------------------------
License Number | 110171
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------