C00125;TA103448;653M115;1;;Michael Kovacs;Foot Specialist of Long Island;119 New York Ave;Massapequa;NY;11758;01/24/25
C00125;TA103448;TDIMM115;3;;Michael Kovacs;Foot Specialist of Long Island;119 New York Ave;Massapequa;NY;11758;01/24/25
