Healthcare Provider Details

I. General information

NPI: 1023936374
Provider Name (Legal Business Name): URBAN AESTHETIC MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TOWN SQUARE PL STE 405
JERSEY CITY NJ
07310-2778
US

IV. Provider business mailing address

100 TOWN SQUARE PL STE 405
JERSEY CITY NJ
07310-2778
US

V. Phone/Fax

Practice location:
  • Phone: 917-621-6854
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HAROON CHAUDHRY
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 917-621-6854