Individual
DONALD CEDRIC WALLERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2310 EASTCHESTER RD, BRONX, NY 10469-5911
(718) 519-6340
(718) 519-7898
Mailing address
73 ALONA DR, MAHOPAC, NY 10541-1042
(718) 519-6340
(718) 519-7898
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
144699
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01042442
—
NY
Enumeration date
07/02/2006
Last updated
07/12/2012
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