MEDICARE: TELOS HEALTH SYSTEMS VA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1942159280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TELOS HEALTH SYSTEMS VA LLC

Provider Business Mailing Address
First Line	:	980 SYLVAN AVE
Second Line	:
City	:	ENGLEWOOD CLIFFS
State	:	NJ
Zip	:	07632-3315
Country	:	US
Telephone Number	:	201-217-6777
Fax Number	:

Provider Business Practice Location Address
First Line	:	980 SYLVAN AVE
Second Line	:
City	:	ENGLEWOOD CLIFFS
State	:	NJ
Zip	:	07632-3315
Country	:	US
Telephone Number	:	201-217-6777
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	PETER BAILEY
Credential	:
Telephone Number	:	609-480-0119

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	02/09/2026

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