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General NPI Number Information
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NPI Number | 1588578801
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Entity Type | Organization
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Legal Business Name | INFECTIOUS DISEASES & TRAVEL MEDICINE CENTER OF WALLINGFORD PLLC
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 850 N MAIN STREET EXT BUILDING 2, UNIT 1B
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City | WALLINGFORD
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State | CT
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Zip | 06492-2400
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Country | US
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Telephone | 617-653-9938
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Fax |
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Provider Business Mailing Address
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Address Line | 850 N MAIN STREET EXT BUILDING 2, UNIT 1B
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City | WALLINGFORD
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State | CT
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Zip | 06492-2400
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. OGHENERUONA ODILI
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Credential | MD
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Telephone | 203-701-1567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State | NULL
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