... E 25TH ST","","NEW YORK","NY","100102547","US","2124814464","","05/23/2005","07/08/2007","","","","F","","","","","","231H00000X","000396-1","NY","Y","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","M72081","04","NY","PROVIDER ...